BACKGROUND:Degenerative scoliosis is defined as a condition that occurs in adulthood with a coronal cobb angle of the spine>10° accompanied by sagittal deformity and rotational subluxation,which often produces symptoms of spinal cord and nerve compression,such as lumbar pain,lower limb pain,numbness,weakness,and neurogenic claudication.The finite element method is a mechanical analysis technique for computer modelling,which can be used for spinal mechanics research by building digital models that can realistically restore the human spine model and design modifications. OBJECTIVE:To review the application of finite element method in the etiology and treatment of degenerative scoliosis. METHODS:The literature databases CNKI,PubMed,and Web of Science were searched for articles on the application of finite element method in degenerative scoliosis published before October 2023.Search terms were"finite element analysis,biomechanics,stress analysis,degenerative scoliosis,adult spinal deformity"in Chinese and English.Fifty-four papers were finally included. RESULTS AND CONCLUSION:(1)The biomechanical findings from the degenerative scoliosis model constructed using the finite element method were identical to those from the in vivo experimental studies,which proves that the finite element method has a high practical value in degenerative scoliosis.(2)The study of the etiology and treatment of degenerative scoliosis by the finite element method is conducive to the prevention of the occurrence of the scoliosis,slowing down the progress of the scoliosis,the development of a more appropriate treatment plan,the reduction of complications,and the promotion of the patients'surgical operation.(3)The finite element method has gradually evolved from a single bony structure to the inclusion of soft tissues such as muscle ligaments,and the small sample content is increasingly unable to meet the research needs.(4)The finite element method has much room for exploration in degenerative scoliosis.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective To evaluate the effects of fasting and high-fat diet on the pharmacokinetics of rabeprazole sodium enteric-coated tablets in healthy Chinese subjects.Methods A single-center,randomized,open,two-agent,two-sequence,four-cycle,fully repeated crossover,single-dose trial design was used in this study,healthy subjects were assigned to receive single dose of rabeprazole sodium enteric-coated tablets 0.1 g in either fasting or high-fat diet state,and blood samples were taken at different time points,respectively.The concentrations of rabeprazole sodium enteric-coated in plasma were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS),the model method of the non-compartmental was used to calculate the pharmacokinetic parameters by Phoenix WinNonlin 8.2.Results The main pharmacokinetic parameters of rabeprazole sodium enteric-coated tablets in fasting state and high-fat diet state were as follows:Cmax were(339.63±156.47)and(318.86±132.13)ng·mL-1;t1/2 were(2.34±0.68)and(3.60±2.40)h;AUC0_t were(556.62±251.65)and(528.50±201.78)ng·mL-1·h;AUC0-∞ were(563.39±255.69)and(535.15±203.24)ng·mL-1·h;tmax were 3.65 and 6.99 h.After high-fat diet,the Cmax and AUC of rapeprazole sodium after high-fat and high-calorie diet decreased,Cmax decreased by 6.12％,AUC0-t decreased by 5.05％,AUC0-∞ decreased by 5.01％,andtmaxwas delayed by about 3.34 h.Cmax,AUC0-t and AUC0-∞ 90％confidence interval were 73.13％-115.10％,83.22％-112.28％and 83.40％-112.13％,respectively.Neither was between 85.00％-125.00％.Conclusion High-fat diet affects the absorption rate and degree of rabeprazole sodium enteric-coated,so it is suitable to be administered on an empty stomach.

BACKGROUND:The highest incidence of spinal fracture is in the thoracolumbar segment,and its symptoms are back pain,posterior convexity deformity,activity limitation,or with spinal cord nerve injury causing lower limb pain,numbness,and even paraplegia and other complications.The finite element method is a digital computer modeling technique,which can simulate the physical model and carry out force analysis realistically.OBJECTIVE:To review the application of finite element method in thoracolumbar spine fractures.METHODS:We searched the Chinese and English literature databases PubMed,Web of Science,and CNKI for relevant literature on the application of the finite element analysis method in spinal thoracolumbar fracture published before March 2024.The search terms in Chinese and English were:finite element analysis methods,biomechanical phenomena,stress analysis,thoracolumbar fractures,spinal fractures.Finally,55 papers were included.RESULTS AND CONCLUSION:(1)The exploration of thoracolumbar fractures caused by different etiologies(osteoporotic,traumatic,and pathological)through the finite element method is conducive to a deeper understanding of the biomechanics of various types of thoracolumbar fractures,and to improve the individualized and fine-tuned treatment of thoracolumbar fractures.(2)The finite element analysis of a single sample or a small number of samples has the chance,and a larger number of samples are required for the future finite element analysis to reduce the chance caused by the sample.(3)The rigid structure of bones alone cannot meet the biomechanical working conditions of the integrity of the physical object,and future finite element models need to incorporate all the structures of the physical object(e.g.,soft tissues,such as muscles and ligaments)as far as possible.(4)The finite element method has been used in more studies on osteoporotic and traumatic thoracolumbar spine fractures,which will need to be more in-depth in the future,and less in the field of pathologic thoracolumbar fractures,which has a wider scope for future research.

Objective:To explore the clinical features of death in children with acute encephalopathy associated with influenza and corona virus disease 2019（COVID-19）and to enhance pediatrician's understanding of this disease.Methods:Clinical data of children with influenza and COVID-19-related acute encephalopathy hospitalized in Pediatric Intensive Care Unit of Children's Hospital Affiliated to Soochow University from September 2021 to July 2023 were retrospectively analyzed.The cases were divided into survival group and death group according to outcome.The general condition，clinical manifestations，auxiliary examination and treatment between the two groups were compared and analyzed.Results:A total of 41 pediatric patients were enrolled.In the death group,there were 17 cases,including 15 cases of acute necrotizing encephalopathy (ANE); among them,there were 7 male patients and 10 female patients,with a median age of 3.50 years.Eight patients were infected with influenza A virus,3 with influenza B virus,and 6 with SARS-CoV-2.The survival group comprised 24 cases,including 10 cases of ANE; among them,there were 16 male patients and 8 female patients,with a median age of 4.33 years.Fourteen patients were infected with influenza A virus,4 with influenza B virus,and 6 with SARS-CoV-2.None of the patients in the death group has received influenza and COVID-19 vaccines within 1 year before infection.Common symptoms were fever and disturbance of consciousness in the death group，eight cases had mild cough，seven cases had convulsions ≥three times，one case had two convulsions，nine cases had only one seizure，of which five cases were epileptic status.One case had delirium before convulsions.Seventeen cases began to fall into a coma (6.50±1.50) hours after their first onset of convulsion.Two patients had secondary pulmonary infection.Nine cases showed significantly elevated interleukin-6,while 17 cases had normal cerebrospinal fluid cell counts and 14 cases had elevated protein levels.All 17 cases underwent cranial CT scans,among which 13 showed symmetric necrosis of the bilateral thalami.All patients in the death group underwent glucocorticoid and intravenous immunoglobulin pulse therapy.Eleven patients received continuous renal replacement therapy,ten patients received intrathecal dexamethasone injection,and two patients were treated with tocilizumab.One patient underwent extracorporeal membrane oxygenation.Among the eight influenza patients,neuraminidase inhibitors were first administered 48 hours after the onset of fever.None of the six patients infected with SARS-CoV-2 received nirmatrelvir/ritonavir antiviral treatment.The causes of death in 17 patients included ANE(15 cases) and secondary infections(2 cases).Compared with the survival group,the incidence of brainstem involvement,shock,and low Glasgow coma scores (GCS ≤ 4) were significantly higher in the death group(15/17 vs.2/24， χ 2=26.18， P<0.001；16/17 vs.5/24， χ 2=21.39， P<0.001；14/17 vs.5/24， χ 2=15.15， P<0.001). Conclusion:Acute encephalopathy is primarily characterized by recurrent convulsions and disturbances of consciousness.Influenza and COVID-19 are the main causes.Cranial imaging is helpful for clinical diagnosis.Involvement of the brainstem,occurrence of shock,and GCS≤4 are associated with a higher fatality rate of ANE.

As a new type of production factor that can empower the development of new quality productivity, the data element is an important engine to promote the high quality development of the industry. Traditional Chinese medicine(TCM) dispensing is the most basic work of TCM clinical pharmacy, and its quality directly affects the clinical efficacy of TCM. The integration of data elements and TCM dispensing can stimulate the innovation and vitality of the TCM dispensing industry and promote the high-quality and sustainable development of the industry. A large-scale, detailed, and systematic study on TCM dispensing was conducted. The innovative practice path of data fusion construction in the whole process of TCM dispensing was investigated by integrating the digital resources "nine full activities" of TCM dispensing, creating the digital dictionary of "TCM clinical information data elements", and exploring innovative applications of TCM dispensing driven by data and technology, so as to promote the standardized, digital, and intelligent development of TCM dispensing in medical health services. The research content of this project was successfully selected as the second batch of "Data element×" typical cases of National Data Administration in 2024, which is the only selected case in the field of TCM.
Medicine, Chinese Traditional/methods* ; Drugs, Chinese Herbal ; Humans

BACKGROUND:The highest incidence of spinal fracture is in the thoracolumbar segment,and its symptoms are back pain,posterior convexity deformity,activity limitation,or with spinal cord nerve injury causing lower limb pain,numbness,and even paraplegia and other complications.The finite element method is a digital computer modeling technique,which can simulate the physical model and carry out force analysis realistically.OBJECTIVE:To review the application of finite element method in thoracolumbar spine fractures.METHODS:We searched the Chinese and English literature databases PubMed,Web of Science,and CNKI for relevant literature on the application of the finite element analysis method in spinal thoracolumbar fracture published before March 2024.The search terms in Chinese and English were:finite element analysis methods,biomechanical phenomena,stress analysis,thoracolumbar fractures,spinal fractures.Finally,55 papers were included.RESULTS AND CONCLUSION:(1)The exploration of thoracolumbar fractures caused by different etiologies(osteoporotic,traumatic,and pathological)through the finite element method is conducive to a deeper understanding of the biomechanics of various types of thoracolumbar fractures,and to improve the individualized and fine-tuned treatment of thoracolumbar fractures.(2)The finite element analysis of a single sample or a small number of samples has the chance,and a larger number of samples are required for the future finite element analysis to reduce the chance caused by the sample.(3)The rigid structure of bones alone cannot meet the biomechanical working conditions of the integrity of the physical object,and future finite element models need to incorporate all the structures of the physical object(e.g.,soft tissues,such as muscles and ligaments)as far as possible.(4)The finite element method has been used in more studies on osteoporotic and traumatic thoracolumbar spine fractures,which will need to be more in-depth in the future,and less in the field of pathologic thoracolumbar fractures,which has a wider scope for future research.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective:To explore the clinical features of death in children with acute encephalopathy associated with influenza and corona virus disease 2019（COVID-19）and to enhance pediatrician's understanding of this disease.Methods:Clinical data of children with influenza and COVID-19-related acute encephalopathy hospitalized in Pediatric Intensive Care Unit of Children's Hospital Affiliated to Soochow University from September 2021 to July 2023 were retrospectively analyzed.The cases were divided into survival group and death group according to outcome.The general condition，clinical manifestations，auxiliary examination and treatment between the two groups were compared and analyzed.Results:A total of 41 pediatric patients were enrolled.In the death group,there were 17 cases,including 15 cases of acute necrotizing encephalopathy (ANE); among them,there were 7 male patients and 10 female patients,with a median age of 3.50 years.Eight patients were infected with influenza A virus,3 with influenza B virus,and 6 with SARS-CoV-2.The survival group comprised 24 cases,including 10 cases of ANE; among them,there were 16 male patients and 8 female patients,with a median age of 4.33 years.Fourteen patients were infected with influenza A virus,4 with influenza B virus,and 6 with SARS-CoV-2.None of the patients in the death group has received influenza and COVID-19 vaccines within 1 year before infection.Common symptoms were fever and disturbance of consciousness in the death group，eight cases had mild cough，seven cases had convulsions ≥three times，one case had two convulsions，nine cases had only one seizure，of which five cases were epileptic status.One case had delirium before convulsions.Seventeen cases began to fall into a coma (6.50±1.50) hours after their first onset of convulsion.Two patients had secondary pulmonary infection.Nine cases showed significantly elevated interleukin-6,while 17 cases had normal cerebrospinal fluid cell counts and 14 cases had elevated protein levels.All 17 cases underwent cranial CT scans,among which 13 showed symmetric necrosis of the bilateral thalami.All patients in the death group underwent glucocorticoid and intravenous immunoglobulin pulse therapy.Eleven patients received continuous renal replacement therapy,ten patients received intrathecal dexamethasone injection,and two patients were treated with tocilizumab.One patient underwent extracorporeal membrane oxygenation.Among the eight influenza patients,neuraminidase inhibitors were first administered 48 hours after the onset of fever.None of the six patients infected with SARS-CoV-2 received nirmatrelvir/ritonavir antiviral treatment.The causes of death in 17 patients included ANE(15 cases) and secondary infections(2 cases).Compared with the survival group,the incidence of brainstem involvement,shock,and low Glasgow coma scores (GCS ≤ 4) were significantly higher in the death group(15/17 vs.2/24， χ 2=26.18， P<0.001；16/17 vs.5/24， χ 2=21.39， P<0.001；14/17 vs.5/24， χ 2=15.15， P<0.001). Conclusion:Acute encephalopathy is primarily characterized by recurrent convulsions and disturbances of consciousness.Influenza and COVID-19 are the main causes.Cranial imaging is helpful for clinical diagnosis.Involvement of the brainstem,occurrence of shock,and GCS≤4 are associated with a higher fatality rate of ANE.