BACKGROUND:Nobiletin has been found to improve lipopolysaccharide-induced abnormal activation of microglia,excessive release of inflammatory factors and redox imbalance.However,the specific mechanism is not fully understood. OBJECTIVE:To investigate the molecular mechanism by which nobiletin can inhibit lipopolysaccharide-induced inflammation in BV2 microglia. METHODS:Passage 3 BV2 microglia were divided into three groups:control group was cultured for 24 hours(without any treatment).Lipopolysaccharide group was treated with 10 μg/mL lipopolysaccharide for 24 hours.Lipopolysaccharide+nobiletin group was treated with 20 μmol/L nobiletin for 6 hours and then 10 μg/mL lipopolysaccharide for 24 hours.After the processing,cell proliferation was detected by CCK-8 assay.The level of intracellular reactive oxygen species was detected by fluorescent probe.The mRNA expression levels of nuclear factor κB p65,tumor necrosis factor α,and interleukin-1β were detected by qRT-PCR.The protein expression levels of nuclear factor κB p65,p-nuclear factor κB p65,tumor necrosis factor α,and interleukin-1β were detected by western blot assay. RESULTS AND CONCLUSION:(1)Compared with the control group,the proliferation activity of lipopolysaccharide group was decreased(P<0.001).Compared with the lipopolysaccharide group,the cell proliferation activity of lipopolysaccharide+nobiletin group was increased(P<0.001).(2)Compared with the control group,the level of intracellular reactive oxygen species was increased in the lipopolysaccharide group(P<0.001).Compared with the lipopolysaccharide group,the level of intracellular reactive oxygen species was decreased in the lipopolysaccharide+nobiletin group(P<0.01).(3)Compared with the control group,the mRNA expression levels of tumor necrosis factor α and interleukin-1β were increased in the lipopolysaccharide group(P<0.001,P<0.01).Compared with the lipopolysaccharide group,mRNA expression levels of tumor necrosis factor α and interleukin-1β were decreased in the lipopolysaccharide+nobiletin group(P<0.01,P<0.05).(4)Compared with the control group,the protein expression levels of p-nuclear factor κB p65,tumor necrosis factor α,and interleukin-1β in were increased the lipopolysaccharide group(P<0.001).Compared with the lipopolysaccharide group,the expression of p-nuclear factor κB p65,tumor necrosis factor α,and interleukin-1β was decreased in the lipopolysaccharide+nobiletin group(P<0.001).(5)These findings suggest that nobiletin attenuates lipopolysaccharide-induced inflammatory response in BV2 microglia by suppressing nuclear factor-κB signaling pathway.

Objective To analyze the status of 2 649 suspected pertussis patients in Xi'an and the changes in laboratory diagnostic indi-cators.Methods 2 649 patients with suspected pertussis who visited the Second Affiliated Hospital of Xi'an Jiaotong University from June 2023 to May 2025 were collected as the research subjects.Nasopharyngeal swabs were collected from the patients,and pertussis nucleic acid was detected by polymerase chain reaction(PCR)-fluorescence probe method.Laboratory diagnostic indicators were an-alyzed.Results Among the 2 649 samples tested,250 were positive for pertussis nucleic acid,with a positive detection rate of 9.44%.The detection rate in male patients was 9.37%(127/1 356),and in female patients was 9.51%(123/1 293),with difference no was statis-tically significant between the two groups(χ2=0.019,P=0.894).There was a statistically significant difference in the positive detection rate among different age groups(χ2=46.473,P<0.05),with the highest positive detection rate in the 7～19 age group(14.98%).The prevalence of pertussis showed a seasonal characteristic with a peak from April to September.21.2%(53/250)of the positive patients were mixed infections.In the 1～14 age group,the white blood cell count(WBC),lymphocyte percentage(LYMP%),and lymphocyte count(LYMP#)in the pertussis infection group were higher than those in the Mycoplasma pneumoniae(MP)infection group(t=10.179,5.819,8.614)and the Respiratory syncytial virus(RSV)infection group(t=16.570,2.618,7.185),and the differences were statistically significant(all P<0.01),respectively.In the＞14 age group,the LYMP%and LYMP#in the pertussis infection group were higher than those in the MP infection group(t=3.275,2.319)and the RSV infection group(t=2.401,4.617),and the differences were statistically significant(all P<0.05),respectively.Conclusion The pertussis infection status in Xi'an area from 2023 to 2025 shows significant char-acteristics in terms of age,season and laboratory test results.It is necessary to further improve the pertussis surveillance system in this area,optimize the clinical diagnosis and treatment process and strengthen the vaccination work of pertussis vaccine.

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.

Objectives:To evaluate the treatment effectiveness on Cobb angle systematically of observation,bracing,specific exercise therapy(Schroth,SEAS,etc),traditional Chinese medicine therapy,rehabilitation tech-niques,and general exercise therapy in patients with mild to moderate adolescent idiopathic scoliosis(AIS).Methods:A systematic search of Pubmed,The Cochrane Library,Embase,Web of Science,CNKI,WanFang,and VIP databases was performed for studies related to conservative treatment methods for adolescent scoliosis patients from the time of their inceptions to October 2023.After 2 investigators independently screened the literature,extracted the information,and evaluated the risk of bias in the included studies,reticulated meta-analysis was performed using Stata 14.0 software.Results:A total of 16 studies,including 923 patients,were included.Meta-analysis showed that the surface under the cumulative ranking curve of AIS conservative treat-ment on patients'Cobb angle was,in descending order,as follows:Schroth+Myofascial chain rehabilitation technique＞Schroth+Cheneau brace＞Core stability training+Electro-acupuncture and chiropractic＞Schroth+Myofas-cial chain manipulation＞Schroth+Different sitting position horse riding training＞Schroth+"Segmental"spinal manipulation＞Schroth+"Five-line Du-unblocking"acupuncture＞Schroth+Pingle bone-setting manipulation＞Schroth+Suspension training＞Core stability training＞"Three-step Seven-method"massage＞"Five-line Du-un-blocking"acupuncture＞Schroth＞Active self-correction＞Observation only＞Schroth home therapy+Three-dimen-sional plane massage＞Proprioceptive neuromuscular facilitation＞Schroth home therapy.Conclusions:Schroth combined with myofascial chain rehabilitation technique is the most effective in the conservative treatment modalities of mild to moderate AIS.

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.

Objective To investigate the clinical effect of far lateral approach surgery under unilateral biportal endoscope(UBE)for lumbar foraminal stenosis.Methods From June 2021 to August 2022,39 patients with lumbar foraminal stenosis were treated with far lateral approach surgery under UBE in our department.The patients were placed at the standard prone position,and a longitudinal line was drawn about 2 cm from the lateral edge of the upper and lower pedicles.Transverse incisions were made at the two intersection points of the horizontal line at the midpoint of the lateral edge of the upper and lower pedicles.After inserting the gradually enlarged sleeves to expand the space,the enlargement of the intervertebral foramen and release of the nerve root were completed under the direct view of UBE.The Visual Analogue Scale(VAS)of leg pain and the Oswestry Disability Index(ODI)were compared before and after operation.The effectiveness was evaluated according to the modified MacNab criteria at 12 months after operation.Results The operations were successfully completed in all the 39 cases.The operation time was(105.5±14.8)min,and the blood loss was(26.7±8.8)ml.The tear of adventitial nerve root occurred in 1 case during operation,and there was no nerve injury symptom after operation.One case of suspected infection occurred after operation and recovered after conservative treatment.All the 39 patients got out of bed with waist circumference on the first day after operation.The intervertebral foramen height measured by sagittal CT at 3 d after operation was(1.62±0.26)cm,which was significantly higher than that before operation[(1.51±0.28)cm;t=-4.010,P=0.000].The intervertebral foramen width was significantly greater than preoperation[(1.24±0.17)cm vs.(0.96±0.15)cm;t=-14.811,P=0.000].The area of intervertebral foramen was significantly larger than preoperation[(1.40±0.19)cm2 vs.(1.05±0.22)cm2;t=-12.874,P=0.000].The VAS of leg pain at 1 d,and 1,3,and 6 months after operation were significantly lower than those before operation(all P=0.000),and the VAS scores gradually decreased with the increase of time.The ODI was significantly lower at 1,3,and 6 months after operation than that before operation(all P=0.000),and the ODI decreased gradually with the increase of time.According to the modified MacNab criteria,at 12 months after operation,33 cases were excellent,4 cases were good,and 2 cases were fair,with an excellent and good rate of 94.9％(37/39).Conclusions Far lateral approach surgery under UBE for lumbar foraminal stenosis has significant effect on the relief of lumbago and leg pain and the improvement of lumbar function.It has little damage to lumbar stability and does not need internal fixation,which is worthy of clinical application and promotion.

Objectives:To evaluate the treatment effectiveness on Cobb angle systematically of observation,bracing,specific exercise therapy(Schroth,SEAS,etc),traditional Chinese medicine therapy,rehabilitation tech-niques,and general exercise therapy in patients with mild to moderate adolescent idiopathic scoliosis(AIS).Methods:A systematic search of Pubmed,The Cochrane Library,Embase,Web of Science,CNKI,WanFang,and VIP databases was performed for studies related to conservative treatment methods for adolescent scoliosis patients from the time of their inceptions to October 2023.After 2 investigators independently screened the literature,extracted the information,and evaluated the risk of bias in the included studies,reticulated meta-analysis was performed using Stata 14.0 software.Results:A total of 16 studies,including 923 patients,were included.Meta-analysis showed that the surface under the cumulative ranking curve of AIS conservative treat-ment on patients'Cobb angle was,in descending order,as follows:Schroth+Myofascial chain rehabilitation technique＞Schroth+Cheneau brace＞Core stability training+Electro-acupuncture and chiropractic＞Schroth+Myofas-cial chain manipulation＞Schroth+Different sitting position horse riding training＞Schroth+"Segmental"spinal manipulation＞Schroth+"Five-line Du-unblocking"acupuncture＞Schroth+Pingle bone-setting manipulation＞Schroth+Suspension training＞Core stability training＞"Three-step Seven-method"massage＞"Five-line Du-un-blocking"acupuncture＞Schroth＞Active self-correction＞Observation only＞Schroth home therapy+Three-dimen-sional plane massage＞Proprioceptive neuromuscular facilitation＞Schroth home therapy.Conclusions:Schroth combined with myofascial chain rehabilitation technique is the most effective in the conservative treatment modalities of mild to moderate AIS.

Objective To analyze the status of 2 649 suspected pertussis patients in Xi'an and the changes in laboratory diagnostic indi-cators.Methods 2 649 patients with suspected pertussis who visited the Second Affiliated Hospital of Xi'an Jiaotong University from June 2023 to May 2025 were collected as the research subjects.Nasopharyngeal swabs were collected from the patients,and pertussis nucleic acid was detected by polymerase chain reaction(PCR)-fluorescence probe method.Laboratory diagnostic indicators were an-alyzed.Results Among the 2 649 samples tested,250 were positive for pertussis nucleic acid,with a positive detection rate of 9.44%.The detection rate in male patients was 9.37%(127/1 356),and in female patients was 9.51%(123/1 293),with difference no was statis-tically significant between the two groups(χ2=0.019,P=0.894).There was a statistically significant difference in the positive detection rate among different age groups(χ2=46.473,P<0.05),with the highest positive detection rate in the 7～19 age group(14.98%).The prevalence of pertussis showed a seasonal characteristic with a peak from April to September.21.2%(53/250)of the positive patients were mixed infections.In the 1～14 age group,the white blood cell count(WBC),lymphocyte percentage(LYMP%),and lymphocyte count(LYMP#)in the pertussis infection group were higher than those in the Mycoplasma pneumoniae(MP)infection group(t=10.179,5.819,8.614)and the Respiratory syncytial virus(RSV)infection group(t=16.570,2.618,7.185),and the differences were statistically significant(all P<0.01),respectively.In the＞14 age group,the LYMP%and LYMP#in the pertussis infection group were higher than those in the MP infection group(t=3.275,2.319)and the RSV infection group(t=2.401,4.617),and the differences were statistically significant(all P<0.05),respectively.Conclusion The pertussis infection status in Xi'an area from 2023 to 2025 shows significant char-acteristics in terms of age,season and laboratory test results.It is necessary to further improve the pertussis surveillance system in this area,optimize the clinical diagnosis and treatment process and strengthen the vaccination work of pertussis vaccine.

Objective To investigate the clinical effect of far lateral approach surgery under unilateral biportal endoscope(UBE)for lumbar foraminal stenosis.Methods From June 2021 to August 2022,39 patients with lumbar foraminal stenosis were treated with far lateral approach surgery under UBE in our department.The patients were placed at the standard prone position,and a longitudinal line was drawn about 2 cm from the lateral edge of the upper and lower pedicles.Transverse incisions were made at the two intersection points of the horizontal line at the midpoint of the lateral edge of the upper and lower pedicles.After inserting the gradually enlarged sleeves to expand the space,the enlargement of the intervertebral foramen and release of the nerve root were completed under the direct view of UBE.The Visual Analogue Scale(VAS)of leg pain and the Oswestry Disability Index(ODI)were compared before and after operation.The effectiveness was evaluated according to the modified MacNab criteria at 12 months after operation.Results The operations were successfully completed in all the 39 cases.The operation time was(105.5±14.8)min,and the blood loss was(26.7±8.8)ml.The tear of adventitial nerve root occurred in 1 case during operation,and there was no nerve injury symptom after operation.One case of suspected infection occurred after operation and recovered after conservative treatment.All the 39 patients got out of bed with waist circumference on the first day after operation.The intervertebral foramen height measured by sagittal CT at 3 d after operation was(1.62±0.26)cm,which was significantly higher than that before operation[(1.51±0.28)cm;t=-4.010,P=0.000].The intervertebral foramen width was significantly greater than preoperation[(1.24±0.17)cm vs.(0.96±0.15)cm;t=-14.811,P=0.000].The area of intervertebral foramen was significantly larger than preoperation[(1.40±0.19)cm2 vs.(1.05±0.22)cm2;t=-12.874,P=0.000].The VAS of leg pain at 1 d,and 1,3,and 6 months after operation were significantly lower than those before operation(all P=0.000),and the VAS scores gradually decreased with the increase of time.The ODI was significantly lower at 1,3,and 6 months after operation than that before operation(all P=0.000),and the ODI decreased gradually with the increase of time.According to the modified MacNab criteria,at 12 months after operation,33 cases were excellent,4 cases were good,and 2 cases were fair,with an excellent and good rate of 94.9％(37/39).Conclusions Far lateral approach surgery under UBE for lumbar foraminal stenosis has significant effect on the relief of lumbago and leg pain and the improvement of lumbar function.It has little damage to lumbar stability and does not need internal fixation,which is worthy of clinical application and promotion.

BACKGROUND:Intervertebral disc degeneration is caused by damage and degeneration of the nucleus pulposus and annulus fibrosus tissues inside the intervertebral disc,resulting in structural and functional changes of the intervertebral disc.However,there is yet no effective drug treatment for intervertebral disc degeneration. OBJECTIVE:To investigate the inhibitory effect of syringin on intervertebral disc degeneration. METHODS:A total of 10 male Sprague-Dawley rats were selected,and the coccygeal intervertebral disc(Co4/Co5)of each rat was set as model group,Co5/Co6 intervertebral disc as syringin group,and Co6/Co7 intervertebral disc as control group.The control group did not receive any treatment.In the model group and syringin group,a miniature puncture needle was used to puncture the annulus fibrosus to establish an intervertebral disc degeneration model.Immediately after modeling,2.5 μL of normal saline and syringin solution(5 μmol/L)were given in the model and syringin groups,respectively.Four weeks after injection,the samples were taken.The degree of intervertebral disc degeneration in rats was observed by hematoxylin-eosin and safranine O-fast green staining.The expressions of type Ⅱ collagen,aggrecan and matrix metalloproteinases 3 and 13 in intervertebral disc tissue were analyzed by immunohistochemical staining. RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that in the model group,the height of intervertebral disc decreased,the cartilage endplate became thinner and cracked,the fibrous ring structure was disordered and cracked,and the nucleus pulposus disappeared;in the syringin group,the height of intervertebral disc was normal or slightly lower than that in the control group,the degree of cartilage endplate degeneration was lighter than that in the model group,the fiber circle permutation was relatively regular with no cracks,and the nucleus pulposus was partially shrunk.Safranine O-fast green staining showed that in the model group,the cartilage endplate of the intervertebral disc was defective and the calcified layer of cartilage became thinner,showing obvious degeneration.The structure and morphology of intervertebral disc cartilage endplate in the syringin group recovered to some extent.Immunohistochemical staining showed that,compared with the control group,the expressions of type Ⅱ collagen and aggrecan in the intervertebral disc cartilage were decreased in the model group(P<0.000 1),while the expressions of matrix metalloproteinases 3 and 13 increased(P<0.000 1).Compared with the model group,the expressions of type Ⅱ collagen and aggrecan in the intervertebral disc cartilage tissue were increased in the syringin group(P<0.001,P<0.000 1),while the expressions of matrix metalloproteinases 3 and 13 decreased(P<0.001,P<0.000 1).These results showed that syringin could improve the structure and function of intervertebral disc by inhibiting the expression of matrix metalloproteinases 3 and 13 and increasing the expression of type Ⅱ collagen and aggrecan,thus preventing and slowing down the procession of intervertebral disc degeneration.