Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

To investigate the effect of mitochondrial division inhibitor 1(Mdivi-1)on imiquimod(IMQ)-induced psoriasis-like skin inflammation in mice and its mechanism,female 8-week-old C57BU6 mice were recruited and randomly divided into control group,IMQ model group,IMQ+Mdivi-1 experiment group.IMQ was used to induce the psoriasis-like skin inflammation model in mice.The mice in the experiment group were injected intraperitoneally(i.p.)with Mdivi-1,and the mice in the control group and model group were injected with the same volume of solvent.The mice were sacrificed on the 7th day for sampling.Psoriasis area and severity index(PASI)score was used to evaluate the severity of skin lesions in each group;the reactive oxygen species(R0S)content in skin tissue was detected by fluorescence staining of frozen section;HE staining was used to observe the histomorphologic change of skin lesions;immunohistochemical staining was used to detect the expression of dynamin-related protein 1(Drp1)in the skin of mice;Western blot was used to detect the protein levels of Drp1,NLRP3 and IL-1β in the skin tissues of mice in each group;and the expressions of IL-17A and IL-18 in mouse serum were detected by ELISA.Data showed that the model group had typical psoriatic lesions such as erythema,scale and thickening,and the Mdivi-1 group demonstrated obvious reduction of the lesions.The PASI score of the experiment group was significantly lower than that of the model group.HE staining indicated that the epidermal thickness of the back skin in the treatment group was significantly lower than that in the model group,and Munro microabscess was significantly reduced.R0S fluorescence staining indicated that ROS content in the experiment group was significantly lower than that in the model group;immunohistochemical results showed that the expression of Drp1 protein in the experiment group was significantly lower than that in the model group;Western blot results showed that the expression levels of Drp1,NLRP3 and IL-1 β in the experiment group were significantly lower than those in the model group;ELISA results indicated that the expressions of IL-17A and IL-18 in serum of mice in the experiment group were lower than those in the model group.Taken together,Mdivi-1 can reduce mitochondrial damage and ROS production by inhibiting the expression of Drp1,thereby reducing the production of NLRP3 inflammasome,down-regulating IL-1 β,IL-18 and IL-17A,and alleviating the IMQ-induced psoriasis-like skin inflammation in mice.

Objective: To investigate the coverage of rotavirus vaccination among children under five years in Xiuzhou District of Jiaxing City, so as to provide insights into rotaviral diarrhea control. Methods: The rotavirus vaccination data of children aged two months to five years were extracted from the vaccination clinics of eight township hospitals and community health service centers through the Zhejiang vaccination information system. The coverage of rotavirus vaccination was analyzed among children with different genders, ages, types of vaccines and doses of vaccination. Results: Totally 32 752 children were included, and the coverage of rotavirus vaccination was 47.09%. The coverage of rotavirus vaccination was significantly higher in boys than in girls ( 47.65% vs. 46.46%, P<0.05 ), and a higher vaccination rate was seen in children with local household registration than in those without ( 56.76% vs. 38.75%, P<0.05 ). The vaccination rates of monovalent and pentavalent rotavirus vaccines were 36.90% and 10.18%, respectively. Totally 26 982 doses of rotavirus vaccines were vaccinated, with a mean dose of ( 0.84±1.02 ) per capita, and the vaccination rates of one, two and three doses were 20.75%, 17.37% and 8.96%, respectively. The median age was 6.00 months ( interquartile range, 3.00 months ) among children vaccinated with the first dose. Conclusions The coverage of rotavirus vaccination and full-dose vaccination are low among children under five in Xiuzhou District, with monovalent rotavirus vaccines predominant. Intensified rotavirus vaccination is therefore recommended.

Objective:To investigate the change in serum epidermal growth factor (EGF) level in patients with Parkinson's disease (PD) and correlate it with cognitive impairment.Methods:A total of 154 patients with early PD who received treatment in Hangzhou Third People's Hospital between July 2017 and June 2018 were included in this study. They were randomly divided into mild cognitive impairment (observation group) and no cognitive impairment (control group) according to the severity of cognitive impairment. Cognitive impairment was graded using Montreal cognitive assessment scale. Motor function was assessed using Unified Parkinson's Disease Rating Scale Part III formulated by International Parkinson and Movement Disorder Society. All these assessments were performed at enrollment and at the end of 2-year follow-up. Serum EGF level was measured by double antibody sandwich enzyme-linked immunosorbent assays. Patients without cognitive impairment were divided into four groups according to quartiles of serum EGF levels. The conversion rate of PD-MCI was calculated at 2 years of follow-up and compared between groups.Results:Among 154 patients, 68 (44.16%) patients developed PD-MCI, and 86 (55.84%) patients had no cognitive impairment. Montreal cognitive assessment scale score and serum EGF level in the observation group were (20.01 ± 3.15) points and (267.79 ± 63.18) ng/L, respectively, which were significantly lower than those in the control group [(28.21 ± 2.84) points, (491.53 ± 67.38) ng/L, t = 8.11, 9.03, both P < 0.001]. Unified Parkinson's Disease Rating Scale Part III score in the observation group was significantly higher than that in the control group [(23.47 ± 5.33) points vs. (18.69 ± 4.37) points, t = 5.18, P < 0.001]. Among the first quartile group, 14 (63.64%) patients converted to PD-MCI; while among the fourth quartile group, 2 (9.52%) patients converted to PD-MCI. The conversion rate of PD-MCI in the second, third and fourth quartile groups was significantly lower than that in the first quartile group (χ 2 = 9.73, 14.48, 33.47, all P < 0.05). Conclusion:Cognitive impairment in patients with PD is closely related to serum EGF level. Serum EGF level is a hematological index to predict cognitive impairment in patients with PD. This study is innovative and scientific.

Objective:To explore the characteristics of cerebral blood flow changes in MRI perfusion imaging in patients with Parkinson disease (PD) cognition disorders and its correlation with serum epidermal growth factor (EGF) level.Methods:One hundred and twenty PD patients diagnosed and treated from September 2017 to September 2020 in Hangzhou Third People′s Hospital were selected. According to the presence of mild cognitive impairment (MCI), they were divided into PD-MCI group (60 cases) and PD without cognition impairment (PD-NCI) group (60 cases). Another 60 cases of healthy physical examination during the same period were selected as the normal control group. MRI perfusion imaging was used to evaluate the cerebral vascular perfusion in each group, and the EGF level of each group was determined by enzyme-linked immunosorbent assay and compared.Results:The CBF and CBV in the PD-MCI group and PD-NCI group were lower than those in the normal control group, while the MTT was longer than that in the normal control group:(14.78 ± 2.49), (18.21 ± 2.84) ml/(100 g·min) vs. (18.21 ± 2.84) ml/(100g·min); (1.42 ± 0.29), (1.83 ± 0.31) ml/100 g vs. (2.87 ± 0.54) ml/100 g; (10.53 ± 2.18), (7.85 ± 1.39) s vs. (4.29 ± 1.05) s, and the differences were statistically significant ( P<0.05). The CBF and CBV in the PD-MCI group were lower than those in the PD-NCI group, while MTT was longer than that in the PD-NCI group, and the differences were statistically significant ( P<0.05). The level of serum EGF in the PD-MCI group and PD-NCI group were lower than those in the normal control group: (146.25 ± 30.12), (208.17 ± 21.25) ng/L vs. (242.38 ± 25.46) ng/L; the level of serum EGF in the PD-MCI group was lower than that in the PD-NCI group, and the differences were statistically significant ( P<0.05). CBF, CBV and EGF were linearly positively correlated with Montreal Cognitive Assessment Scale (MoCA) scores ( r1 = 0.810, r2 = 0.732, r3 = 0.825, P<0.05), while MTT was linearly negatively correlated with MoCA scores ( r4 = -0.756, P<0.05). Conclusions:PD-MCI patients have abnormal cerebral blood flow, and serum EGF level decrease. In PD-MCI patients, CBF, CBV and EGF are linearly positively correlated with MoCA scores, while MTT is linearly negatively correlated with MoCA scores.

Objective:To analyze the associations between prenatal and 1-year-old exposure to antibiotics and allergic symptoms in children aged 6-11 months and 18-23 months.Methods:In this study, a prospective birth cohort study was adopted. A total of 2 122 pregnant women were enrolled in Maternal and Child Health Care Center of Ma′anshan from June 2015 to June 2016, and they were followed up from the beginning of pregnancy to children′s 24 months of age. Excluding 564 pairs of mothers and children who were lost to follow-up or with incomplete information on the use of antibiotics and children′s allergic symptoms, a total of 1 558 pairs of mothers and children were included in the analysis of this study. The parents and children′s general demographic information, early-life antibiotic exposure and other data were collected, the information about allergic symptoms in children aged 6-11 months and 18-23 months were investigated by reference to the "International Study of Asthma and Allergies in Childhood (ISAAC)". The univariate and multivariate binary unconditional logistic regression model was used to was used to estimate associations between the effects of early-life antibiotic exposure on allergic symptoms in 2-year-old children.Results:The antibiotic usage rate of pregnant women during pregnancy was 3.4% (53), and the antibiotic usage rates of children between 0 to 2 months, 3 to 5 months, and 6 to 11 months were separately 15.2%(237), 15.5%(242) and 17.3%(269). The total prevalence of allergic diseases in children aged 6 to 11 months was 24.1% (375 children), and the total prevalence of allergic diseases in children aged 18 to 23 months was 22.0% (342 children). After adjust parental (maternal) education level, family monthly income per capita, parental (maternal) allergy history, parental (maternal) age at pregnancy, mother′s Body Mass Index (BMI) before pregnancy, exposure to second-hand smoke during pregnancy, delivery method, child gender, birth weight, preterm birth, the use of antibiotics when children were 3-5 months old ( RR=1.61,95% CI:1.19-2.17) and 6-11 months old ( RR=1.43,95% CI:1.06-1.93) were the risk factors for allergic symptoms at 6-11 months of age; and the use of antibiotics when children were 0-2 months old (RR=1.41, 95% CI: 1.03-1.95), 3-5 months old ( RR=1.54, 95% CI: 1.12-2.11) and 6-11 months old ( RR=1.58, 95% CI: 1.17-2.14) were the risk factors for allergic symptoms at 18-23 months of age. Conclusion:Children′s exposure to antibiotics within 1 year of age was a risk factor for allergic symptoms in children aged 6-11 months and 18-23 months, children should avoid unnecessary antibiotic use in infancy.

Objective:To retrieve, evaluate and integrate domestic and foreign relevant evidence on the prevention of oral mucositis related to chemoradiotherapy in children, and summarize the best evidence, so as to provide clinical practice guidelines for medical staff.Methods:We systematically searched the evidence on the prevention of oral mucositis related to chemoradiotherapy in children in British Medical Journal (BMJ) Best Practice, UpToDate, Joanna Briggs Institute (JBI) Evidence-based Health Care Center Database, National Guideline Clearinghouse, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, United Kingdom National Institute for Health and Care Excellence, International Practice Guideline Registry Platform (Chinese) , Multinational Association of Supportive Care in Cancer, International Society of Oral Oncology, European Society for Medical Oncology, American Society of Clinical Oncology, Cochrane Library, BMJ Journals, PubMed, Embase, China National Knowledge Infrastructure (CNKI) , WanFang Data and China Biology Medicine Database. The evidence included clinical practice guidelines, expert consensus, best practices, systematic reviews and evidence summaries, and the search time limit was to build the database until November 1, 2019. The searched guidelines were independently evaluated by four guideline reviewers, and the rest of literature was independently evaluated by two researchers who received evidence-based training to evaluate the quality of the included literature, combined with the judgment of professionals. Evidence extraction and evidence summary were carried out on literature that met the quality standards.Results:A total of 8 articles were included, including 1 BMJ best practice, 5 JBI evidence summaries, 1 guideline, and 1 systematic review. The best evidence included 16 pieces of evidence in 7 areas of basic oral care, nursing evaluation, diet prevention, physical therapy, drug prevention, fungal infection prevention, and multidisciplinary team management.Conclusions:This study summarizes the best evidence for the prevention of oral mucositis related to chemoradiotherapy in children, and provides clinical practice guidelines for medical staff. Medical institutions should establish preventive measures for children's oral mucositis related to chemoradiotherapy based on the transformation of evidence-based evidence, and establish standardized multidisciplinary collaboration and nursing procedures to improve patient health outcomes.