Kirsten rat sarcoma viral oncogene homolog(KRAS)is a type of gene closely related to human tumors.And it's an important medical index to access the tumor development,prognosis and the efficacy of chemoradiotherapy.RAS mutations,in which KRAS mutations account for up to 85%,are the most common oncogenic driving mutations in human tumors.The most frequent KRAS mutation sites are codons 12,13,61 and 146.Codon G12,as the most frequently mutated one,can be divided into multiple subtypes,with G12D mutation being the most common,followed by G12V,G12C,etc.Colorectal cancer(CRC)is one of the tumors with the highest frequency of KRAS mutations.Both G12D and G12V are the most common mutation subtypes in CRC.In the field of treatments for CRC with KRAS mutations,targeted therapy had not been possible until the release of KRASG12C inhibitors in 2013,and new drugs have been developed one after another since then.This study summarized the mutations of KRAS and the advances in clinical research,including the latest advances in targeted drugs,chemotherapy drugs,immunotherapy drugs,ferroptosis,and other treatment methods.Among them,in terms of targeted drugs,this review explored KRASG12C inhibitors(sotorasib,adagrasib,D-1553,IBI351,etc.),anti-angiogenic drugs(monoclonal antibodies such as bevacizumab,remdesizumab,etc),small molecule multi-target tyrosine kinase inhibitors such as sunitinib,etc.In terms of immunotherapy drugs,there have also been many advances,such as the ARETHUSA clinical trial,which found that temozolomide reduced the tumor mutational burden(TMB)of O-6-methylguanine-DNA methyltransferase(MGMT)deficiency and RAS mutation in patients with advanced metastatic colorectal cancer(mCRC),providing innovative ideas for patient immunotherapy.For example,the combination of xindilimab with bevacizumab,oxaliplatin,and capecitabine can be used for first-line treatment of RAS mutations,microsatellite stability(MSS),and unresectable mCRC.Relevant studies have shown that the combination therapy has good therapeutic potential and controllable tolerability safety.This review explored the mechanisms of KRAS mutations and the latest advances in clinical research and treatment,in order to provide reference for the treatment of KRAS mutated colorectal cancer.

Objective:To investigate the risk factors of pathological complete response(pCR)after neoadjuvant therapy for locally advanced gastric cancer(LAGC)and assess the value of gastric tumor markers for predicting pCR in LAGC patients.Methods:We retrospectively ana-lyzed the clinical and pathological characteristics of 213 patients who underwent radical gastrectomy and gastric tumor marker analysis after neoadjuvant therapy at The Chinse PLA General Hospital First Medical Center,between January 2020 and April 2024(20 and 193 cases in the pCR and non-pCR groups,respectively).The interrelationships among pCR,tumor markers,and clinicopathological features were compared,and independent risk factors for pCR were analyzed.A nomogram was constructed to predict the pCR.Results:Among 213 patients,20(9.4% )achieved pCR.Univariate analysis showed that age(P=0.067),tumor bed diameter(P<0.001),gastrin-17 levels(P=0.005),CA72-4 levels(P=0.073),pepsinogen ratio(P=0.024),and neoadjuvant immunotherapy(P=0.022)were strongly associated with pCR in LAGC pa-tients.Multivariate analysis showed that neoadjuvant immunotherapy,CA72-4 levels<2.5 U/mL,gastrin-17 levels<1.48 pmol/L,and tumor bed diameter<2.85 cm were independent predictive factors for pCR in LAGC patients(P<0.05).These indicators were incorporated into a nomogram prediction model;an receiver operating characteristic curve(ROC)was plotted with an AUC(95% CI)of 0.863(0.785-0.942).The calibration and decision curves suggested that the nomogram was well calibrated and had a good net benefit.Conclusions:Gastric tumor markers can effectively predict pCR after neoadjuvant therapy in LAGC patients.Our nomogram showed a good predictive ability for pCR.Thus,our findings can serve as a useful reference for clinical decision making for LAGC patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective: To investigate the expression，prognosis and biological role of hepatocyte nuclear factor 4A (HNF4A) in gastric cancer，and to study its effect on the proliferation of gastric cancer cells． Methods: Tumor Immune Estimation Resource 2. 0 (TIMER2. 0) and Gene Expression Profiling Interactive Analysis ( GEPIA2) databases were used to analyze the relative expression levels of HNF4A in gastric cancer and normal tissue，KM Plotter was used to analyze the correlation between the expression level of HNF4A and the survival rate of gastric cancer patients，TISIDB database and R language (4. 1. 2) were used to analyze whether HNF4A was involved in the immune regulation process of gastric cancer．cBioPortal database was used to analyze the mutations of HNF4A in gastric cancer，GSEA 4. 2 was used to analyze the functional enrichment of HNF4A，and LinkedOmics database was used to predict the genes that might be regulated by HNF4A．The relative expression of HNF4A in gastric cancer and adjacent tissues was detected by qRT-PCR , Western blot and immunohistochemistry (IHC) ．The proliferation and cell cycle of gastric cancer cells were analyzed by CCK-8，EdU，colony forming assay and flow cytometry. Results : The expression of HNF4A increased in gastric cancer tissues (P ＜0. 05) ，and the overall survival rate of gastric cancer patients with high HNF4A expression was worse (P＜0. 001) ．HNF4A was mainly missense mutated in gastric cancer．Immune cell infiltration showed that HNF4A was associated with B lymphocytes，CD8 + T cells， neutrophils，macrophages and dendritic cells ( all P ＜0. 001) ． HNF4A was also associated with tumor mutation burden (r = 0. 28，P＜0. 0001) and microsatellite instability (r = 0. 13，P＜0. 01) ．After knockdown of HNF4A， cell proliferation ability was significantly inhibited ，and cell cycle was arrested at G0 / G1 phase． Conclusion HNF4A expression significantly increased in gastric cancer tissues，which is associated with poor prognosis ，and may also be involved in immune regulation． Knockdown of HNF4A can inhibit the proliferation of gastric cancer cells.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Objective:To investigate the clinical efficacy and prognosis of simultaneous resection of synchronous colorectal liver metastasis in patients admitted in different phases.Methods:The retrospective cohort study was conducted. The clinicopathological data of 346 patients who underwent simultaneous resection of synchronous colorectal liver metastasis in the First Affiliated Hospital of Naval Medical University (Changhai Hospital of Shanghai) from January 2000 to April 2021 were collected. There were 217 males and 129 females, aged (58±12)years. Patients under-went simultaneous resection of synchronous colorectal liver metastasis. Observation indicators: (1) clinicopathological features of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021; (2) surgical and postoperative situations of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021; (3) analysis of prognosis of patients with synchro-nous colorectal liver metastasis in 2000?2010 and 2011?2021. Follow-up was conducted using telephone interview or outpatient examination to detect survival of patients. The follow-up was performed once every 3 months, including blood routine test, liver and kidney function test, car-cinoembryonic antigen (CEA) test, CA19-9 test, abdominal B-ultrasound examination, and once every 6 months, including chest computed tomography (CT) plain scan, liver magnetic resonance imaging (MRI) and/or CT enhanced scan, abdominal or pelvic MRI and/or CT enhanced scan, within postoperative 2 year. The follow-up was performed once every 6?12 months within postoperative 2?5 years including above reexaminations. Electronic colonoscopy was performed once a year after operation. The follow-up was up to November 12, 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distuibution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the rank sum test. Kaplan-Meier method was used to calculate survival rates and draw survival curves, and Log-Rank test was used to conduct survival analysis. Results:(1) Clinicopathological features of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021. Of the 346 patients, 59 cases underwent simultaneous resection within 2000?2010 and 287 cases underwent simultaneous resection within 2011?2021. The gender (males and females), cases with or without fundamental diseases, cases with the number of lymph nodes harvested in primary lesion as <12 or ≥12, the tumor diameter of primary lesion, the tumor diameter of liver metastasis lesion, the number of liver metastasis lesions, cases with or without preoperative treatment, cases with or without postoperative treatment, cases with adjuvant therapy as perioperative treatment, surgery or other treatment were 47, 12, 36, 23, 19, 40, (5.5±2.4)cm, (2.1±0.7)cm, 1.6±0.5, 59, 0, 16, 16, 0, 16, 43 in patients admitted in 2000?2010, respectively. The above indicators in patients admitted in 2011?2021 were 170, 117, 121, 166, 58, 229, (4.2±2.0)cm, (3.0±2.0)cm, 1.9±1.4, 208, 79, 34, 235, 74, 29, 184, respectively. There were significant differences in the above indicators between patients admitted in 2000?2010 and 2011?2021 ( χ2=8.73, 7.02, 4.07, t= 4.40, ?6.04, ?3.10, χ2=21.05, 28.82, 26.68, P<0.05). (2) Surgical and postoperative situations of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021. Cases with surgical methods as complete open surgery or laparoscopy combined with open surgery, the operation time, time to postoperative initial liquid food intake, cases with or without postoperative complications, cases with postoperative duration of hospital stay as ≤10 days or >10 days were 58, 1, (281±57)minutes, (5±1)days, 33, 26, 14, 45 in patients admitted in 2000?2010, respec-tively. The above indicators in patients admitted in 2011?2021 were 140, 147, (261±82)minutes, (3±1)days, 233, 54, 198, 89, respectively. There were significant differences in the above indicators between patients admitted in 2000?2010 and 2011?2021 ( χ2=49.04, t=2.24, 7.53, χ2=17.56, 26.02, P<0.05). There was no death in the 346 patients. (3) Analysis of prognosis of patients with synchro-nous colorectal liver metastasis in 2000?2010 and 2011?2021. Of the 346 patients, 295 cases were followed up for 47(range, 1?108)months. Of the 29 patients admitted in 2000?2010 who were followed up, there were 27 cases died. The median survival time, 1-, 3-, 5-year overall survival rates, 1-, 3-, 5-year disease free survival rates of patients admitted in 2000?2010 were 18.0 months (95% confidence interval as 12.7?23.3 months), 82.8%, 11.5%, 3.8%, 53.6%, 8.3%, 4.2%, respec-tively. Of the 266 patients admitted in 2011?2021 who were followed up, there were 109 cases died. The median survival time, 1-, 3-, 5-year overall survival rates, 1-, 3-, 5-year disease free survival rates of patients admitted in 2011?2021 were 54.0 months (95% confidence interval as 38.1?70.4 months), 93.3%, 61.8%, 47.0%, 68.2%, 33.7%, 28.3%, respectively. There were significant differences in overall survival rate and disease free survival rate between patients admitted in 2000?2010 and 2011?2021 ( χ2=47.57, 9.17, P<0.05). Conclusions:With the increase of the operation volume of simultaneous resection of synchronous colorectal liver metastasis, the operation time, time to postoperative initial liquid food intake, postoperative duration of hospital stay and postoperative complications have significantly decreased, while the overall survival rate and disease free survival rate have significantly increased.

Objective:To investigate clinical efficacy of conformal sphincter preservation operation (CSPO) versus intersphincteric resection (ISR) in the treatment of low rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 183 patients with low rectal cancer who were admitted to two medical centers (117 in the Changhai Hospital of Naval Medical University and 66 in the Huashan Hospital of Fudan University) from August 2011 to April 2020 were collected. There were 110 males and 73 females, aged (57±11)years. Of 183 patients, 117 cases undergoing CSPO were allocated into CSPO group, and 66 cases undergoing ISR were allocated into ISR group, respectively. Observation indicators: (1) surgical situations of patients with low rectal cancer in the two groups; (2) postoperative complications of patients with low rectal cancer in the two groups; (3) follow-up; (4) influencing factors for prognosis of patients with low rectal cancer; (5) influencing factors for satisfaction with the anal function of patients with low rectal cancer. Follow-up was conducted using outpatient examination, questionnaire and telephone interview to determine local recurrence, distal metastasis, survival, stomal closure, satisfaction with the anal function of patients. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the rank sum test.The Kaplan-Meier method was used to draw survival curves, and life table method was used to calculate survival rates. Log-rank test was used for survival analysis. Univariate analysis was performed using the linear regression. Variables with P<0.10 in the univariate linear regression analysis were included for multivariate analysis. Multivariate analysis was performed using the COX stepwise regression model and linear regression analysis. Results:(1) Surgical situations of patients with low rectal cancer in the two groups: cases with laparoscopic surgery, operation time, volume of intraoperative blood loss, distance from tumor to distal margin, cases with postoperative chemotherapy, duration of postoperative hospital stay were 44, (165±54)minutes, (142±101)mL, (0.6±0.4)cm, 76, (6.6±2.5)days for the CSPO group, respectively, versus 55, (268±101)minutes, (91±85)mL, (1.9±0.6)cm, 9, (7.9±4.7)days for the ISR group, showing significant differences between the two groups ( χ2=35.531, t=8.995, -3.437, -3.088, χ2=44.681, t=2.267, P<0.05). (2) Postoperative complications of patients with low rectal cancer in the two groups: 19 patients in the CSPO group had complications. There were 6 cases with grade Ⅰ complications, 12 cases with grade Ⅱ complications, 1 case with grade Ⅲb complication. Fourteen patients in the ISR group had complications. There were 4 cases with grade Ⅰ complications, 7 cases with grade Ⅱ complications, 1 case with grade Ⅲa complication, 2 cases with grade Ⅲb complications. There was no significant difference in the postoperative complications between the two groups ( χ2=0.706, P>0.05). Patients with complications in the two groups were improved after symptomatic and supportive treatment. There was no perioperative death in the postoperative 30 days of the two groups. (3) Follow-up: 183 patients received follow-up. Patients of the CSPO group and ISR group were followed up for (41±27)months and (37±19)months, respectively, showing no significant difference between the two groups ( t=-1.104, P>0.05). There were 2 cases with local recurrence and 9 cases with distal metastasis of the CSPO group, respectively, versus 3 cases and 4 cases of the ISR group, showing no significant difference between the two groups ( χ2=1.277, 0.170, P>0.05). The 3-year disease-free survival rate and 3-year total survival rate were 84.0% and 99.0% for the CSPO group, versus 88.6% and 92.8% for the ISR group, showing no significant difference between the two groups ( χ2=0.218, 0.002, P>0.05). The stomal closure rate was 92.16%(94/102) and 96.97%(64/66) for 102 patients of CSPO group and 66 patients of ISR group up to postoperative 12 months,respectively, showing no significant difference between the two groups ( χ2=1.658, P>0.05). Of the 8 cases without stomal closure in the CSPO group, 2 cases refused due to advanced age, 4 cases subjectively refused, and 2 cases were irreducible due to scar caused by radiotherapy. Two cases in the ISR group had no stomal closure including 1 case of postoperative liver metastasis and 1 case of subjective refusal. There were 92 and 61 patients followed up to 12 months after stomal closure, of which 75 cases and 38 cases completed questionnaires of satisfaction with the anal function. The satisfaction score with the anal function was 6.8±2.8 and 5.4±3.0 for CSPO group and ISR group, respectively, showing a significant difference between the two groups ( t=-2.542, P<0.05). Fifty-four cases in the CSPO group and 21 cases in the ISR group had satisfaction score with the anal function >5, showing no significant difference between the two groups ( χ2=3.165, P>0.05). (4) Influencing factors for prognosis of patients with low rectal cancer: results of COX stepwise regression analysis showed that gender and pT staging were independent influencing factors for disease-free survival rate of patients with low rectal cancer ( hazard ratio=2.883, 1.963, 95% confidence interval as 1.090 to 7.622, 1.129 to 3.413, P<0.05). Gender and pT staging were independent influencing factors for total survival rate of patients with low rectal cancer ( hazard ratio=10.963,3.187, 95% confidence interval as 1.292 to 93.063, 1.240 to 8.188, P<0.05). (5) Influencing factors for satisfaction with the anal function of patients with low rectal cancer: results of univariate analysis showed that surgical method and tumor differentiation degree were related factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.464, -1.580, 95% confidence interval as 0.323 to 2.605, -2.950 to -0.209, P<0.05). Results of multivariate analysis showed that surgical method, tumor differentiation degree and preoperative radiotherapy were independent influencing factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.637, -1.456, -1.668, 95% confidence interval as 0.485 to 2.788, -2.796 to -0.116, -2.888 to -0.447, P<0.05). Conclusion:Compared with ISR, CSPO can safely preserve the anus in the treatment of low rectal cancer, without increasing the incidence of postoperative complications, which can also guarantee the oncological safety and improve the postoperative anal function.

Objective:To explore the value of MRI high-resolution T2WI based-radiomics in predicting pathologic complete response (pCR) after neoadjuvant therapy for rectal cancer.Methods:This retrospective study included 80 patients with rectal cancer confirmed by postoperative pathology, who underwent high-resolution imaging of rectal MRI before neoadjuvant therapy from January 2018 to March 2019 in our hospital. After manually delineating the volume of interest (VOI) of the lesion in the high-resolution T2WI image, the radiomics features were extracted, and the least absolute shrinkage and selection operator (LASSO) algorithm was adopted to reduce the dimension and select the features that were valuable for tumor pCR. Using Random algorithm, the data were randomly divided into training set ( n=64) and test set ( n=16) for machine learning, and 4 kinds of machine learning models including decision tree (DT), logistic regression (LR), random forests (RF) and extreme gradient boosting (XGBoost) were established and ROC curves were drawn. The area under the curve (AUC), sensitivity, specificity and 95% CI were respectively calculated, and the difference of ROC curves was compared with DeLong test. Results:Among 80 patients with rectal cancer, there were 15 cases by pCR, accounting for 18.75%, and 65 cases were non-pCR, accounting for 81.25%. A total of 1 409 imaging features were extracted. After dimension reduction by LASSO algorithm, 8 most valuable features were selected. The AUC of DT, LR, RF and XGBoost in the test set group was 0.870, 0.801, 0.912, 0.945, the AUC of XGBoost was the largest, and the differences between XGBoost and DT, LR, RF were statistically significant ( P=0.008; P=0.006; P=0.009), and the pairwise comparisons of DT, LR, RF showed no statistically significant difference ( PLR-RF=0.083; PDT-LR=0.113; PDT-RF=0.879). The sensitivity was 78.57%, 64.29%, 78.57%, 85.71%, and the specificity was 95.38%, 84.62%, 92.31%, 98.46% respectively. The 95% CI was 0.775-0.935, 0.696-0.882, 0.827-0.964, 0.870-0.984. Conclusion:The radiomics based on high-resolution T2WI images has predictive value for pCR after neoadjuvant treatment of rectal cancer. XGBoost model has better predictive efficiency than DT, LR and RF, and can be used to guide clinical individualized treatment and related interventions.

Objective:To evaluate the reliability and repeatability of thoracolumbar AOSpine injury score (TLAOSIS)and thoracolumbar injury severity score (TLICS) classification scoring system in guiding thoracolumbar fracture surgery, and to explore the main reasons for the consistency of classification scoring systems.Methods:Fifty-five thoracolumbar fracture patients with complete clinical data and radiologic data admitted to Second Affiliated Hospital of Zhejiang Chinese Medical University from January 2018 to December 2018 were enrolled. Based on their preoperative X-ray films, CT and MRI, six physicians were assigned to independently determine the classification using the TLAOSIS and TLICS.For the same patient, the classification was identified as inconsistency among 6 observers if there was an observer in a different type.After a 4-week interval, the 55 patients were presented in a random sequence to the same evaluators for repeated evaluation.All data did not contain any marks related to the type. The Cohen's Kappa coefficient was used to determine the interobserver reliability and intraobserver repeatability concerning fracture morphology, posterior ligament classification (PLC) injury classification and neurological function score. Kappa coefficients were used to observe the consistency of pre- and post-measure measurements within each observer.Results:The two classification scoring systems had good consistency and reproducibility in guiding surgery. For TLAOSIS classification scoring system, the interobserver and intraobserver Kappa values for fracture morphology were 0.806 and 0.667; neurological status were 0.937 and 0.891; PLC injury classification were 0.873 and 0.779; the final recommendation surgery were 0.816 and 0.764. For TLICS classification scoring system, the interobserver and intraobserver Kappa values for fracture morphology were 0.878 and 0.788; neurological status were 0.936 and 0.888; PLC injury classification were 0.809 and 0.691; the final recommendation surgery were 0.811 and 0.705. The two classification scoring systems were statistically significant in fracture morphology and PLC injury classification both in the reliability and repeatability analysis ( P<0.05), but there was no significant difference in the neurological function score ( P>0.05). Conclusions:TLAOSIS and TLICS have good consistency and reproducibility in guiding surgery. The fracture morphology and PLC injury classification are the factors influencing the consistency of surgical guidance for the two classification scoring systems.

Objective:To compare the differences between thoracolumbar AO spine injury score (TL AOSIS) and thoracolumbar injury classification and severity score system (TLICS) in guiding thoracolumbar fracture surgery.Methods:A retrospective study was conducted of the 55 patients with complete preoperative imaging data who had been treated for thoracolumbar injuries at Department of Spinal Surgery, The Second Affiliated Hospital to Zhejiang Chinese Medical University from January 2015 to December 2016. They were 34 men and 21 women, aged from 21 to 55 years (average, 37.5 years). Of them, 31 were identified as having normal neurological function and 24 as having impaired neurological function. TL AOSIS and TLICS were used to evaluate respectively all the patients, those with normal neurological function and those with impaired neurological function, and consequently made suggestions whether surgery should be performed or not.Results:Among the 55 patients, by the guidance of TL AOSIS and TLICS respectively, conservative treatment was suggested for 19 and 25 cases, either conservative treatment or surgery for 12 and 13 cases, and surgery for 24 and 17 cases. There was fine consistency between the 2 scoring systems in surgery suggestion for thoracolumbar fracture ( P=0.358). Among the 31 patients with normal neurological function, by the guidance of TL AOSIS and TLICS respectively, conservative treatment was suggested for 19 and 25 cases, either conservative treatment or surgery for 6 and 0 cases, and surgery for 6 and 6 cases. TLICS suggested surgery for significantly more patients than TL AOSIS did ( P=0.033). Among the 24 patients with impaired neurological function, by the guidance of TL AOSIS and TLICS respectively, either conservative treatment or surgery was suggested for 6 and 13 cases, and surgery for 18 and 11 cases. TL AOSIS suggested surgery for significantly more patients than TLICS did ( P=0.039). Conclusion:There is fine consistency between TL AOSIS and TLICS in surgery suggestion for thoracolumbar fracture, but TL AOSIS may lead to more surgery suggestions for the patients with complete burst fracture or impaired neurological function than TLICS.