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.

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 effects of terahertz(THz)radiation on mouse testicular tissue and its potential molecular mechanisms.Methods A total of 125 male C57BL/6J mice(6～8 weeks old)were randomly divided into control group and low-,medium-and high-radiation power groups.The mice of the latter 3 groups were exposed to THz radiation at a frequency of 2.5 T,with an average power density of 38,115,or 318 mW/cm2,for 5 or 10 min.The detection time was immediately or 24 h after exposure.HE staining was used to observe pathological damage.ELISA was employed to detect the expression of inflammatory factors in testicular tissue.RNA-seq was utilized to detect the global changes of gene expression.The differentially expressed genes(DEGs)were screened and bioinformatics was used to cluster them.The screened genes were further analyzed with RT-qPCR to determine the time-dependent and dose-dependent relationships of the expression with THz exposure.Finally,sperm quality was evaluated morphologically using a microscope.Results Three doses of THz radiation exposure did not cause significant pathological damages to mouse testicular tissue.TNF-α expression was increased immediately after exposure at average power density of 115 mW/cm2(P＜0.01),and the expression of IL-1β and TNF-α were both increased when the dose reached 318 mW/cm2(P＜0.01).However,all the 3 factors returned to normal levels in 24 h after exposure.RNA-seq results showed that THz radiation exposure caused abnormal expression of 56 genes.Cluster analysis indicated that these DEGs were mainly enriched in immune and inflammatory responses,enzyme activity,sperm development and capacitation functions.Then for 5 selected key genes,Crisp1,Adam7,Ltf,Rnase9,and Bsph1,the expression of Crisp1 and Rnase9 was decreased immediately after exposure to 115 mW/cm2 THz radiation,the dose of 318 mW/cm2 resulted in obvious changes in the expression of the 5 genes(P＜0.05),and their expression returned to normal levels in 24 h after exposure.Morphological observation displayed that exposure to all the 3 doses of THz had no influence on sperm quality.Conclusion THz radiation exposure causes temporary inflammatory response in testicular tissue and abnormal expression of sperm functions-related genes.However,these changes return to normal 24 h after exposure,and additionally,do not impair sperm quality.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective: To explore the prevalence of anemia and related factors among left-behind children in poverty-stricken rural areas in China, to provide basic information for anemia prevention and treatment for children. Methods: Data from the National Nutrition Improvement Program for Rural Compulsory Education Students in 2016 were used to express the prevalence of anemia among left-behind children. By using the multistage stratified random cluster sampling method, left-behind children of the 6-17-years-old in poverty-stricken rural areas were recruited in this study. Blood hemoglobin concentration of these students was determined by cyanmethemoglobin method. Anemia was judged by the WHO recommended standard and combined with the sea level elevation correction standard. Frequencies of food intake were collected through questionnaires. Data was then available for analysis including the level of hemoglobin and anemia rates. Relationship between anemia and food intakes as well as other influential factors was also analyzed. Results: The overall anemia prevalence (AP) was 11.6% among the participants. Rates of AP among the 6-, 7-, 15- and 16-17-years-old were 21.1%, 18.0%, 20.6% and 17.3%, respectively. Rates of AP among left-behind girls of 10-11-years-old and the 13-15-years-old were significantly higher than those in boys at the same age (P<0.01) group. Factors including: being girls (OR=1.34, 95%CI: 1.23-1.45), at grade 7 to 9 (OR=1.47, 95%CI:1.30-1.67) and mother being migrant worker (OR=1.32, 95%CI:1.16- 1.50) had higher proportions of getting anemia. Factors as living in the western area (OR=0.85, 95%CI: 0.78-0.93), taking breakfast every day (OR=0.70, 95%CI: 0.64-0.76), having meat more than twice per week (OR=0.84, 95%CI: 0.75-0.93) and having two kinds of vegetables per day (OR=0.85, 95%CI: 0.75-0.96) appeared protective. Conclusions Prevalence of anemia in left-behind children from the poverty-stricken rural areas was high, including junior middle school students from grade 7 to 9 at the early stage of youth development, girls and children with mothers as migrant workers. Anemia should be reduced by promoting the protective factors as having breakfast, increasing intakes of meat and fresh vegetables.

BACKGROUND:Atorvastatin has been shown to reduce bone loss and fracture, but its effects on implant osseointegration remain unknown.
OBJECTIVE:To investigate the effects of atorvastatin on implant osseointegration in osteoporotic rats and the underlying mechanisms.
METHODS:Forty-eight Sprague-Dawley rats were randomized into sham-surgery, ovariectomy, and atorvastatin (10 and 20 mg/kg per day) treatment groups, respectively. Al rats received ovariectomy and implant surgery except those in the sham-surgery group. Bone mineral density of the lumbar vertebra, osseointegration ratio and pul-out strength of implants were measured after 12-week treatment.Levels of bone formation and resorption markers in osteoblasts treated with atorvastatin were determined by ELISA. Wnt pathway-relatedgene expression was detected by RT-PCR.
RESULTS AND CONCLUSION:Bone mineral density, osseointegration ratio and pul-out strength of implants were significantly increased in 20 mg/kg per day of atorvastatin treatment group compared with ovariectomy group (P< 0.05). Levels of alkaline phosphatase, osteocalcinand osteoprotegerinwere significantly increased in osteoblasts treated with atorvastatinin vitro(P<0 .05), and the level of osteoclast differentiation factor RANKL was significantly inhibited (P< 0.05). Meanwhile, atorvastatin significantly promoted the mRNA expression of low-density lipoprotein associated protein 5and β-catenin, and inhibited the mRNA expression of dickkopfWnt signal pathway inhibitor 1and sclerostin. Our results suggest that atorvastatin promotes implant osseointegration in osteoporotic rats by activating Wnt/β-catenin signal pathway.

Objective To investigate the distribution of arterial stenosis in patients with ischemic cerebrovas-cular disease and its risk factors .Methods 224 patients with ischemic cerebrovascular disease were divided into four groups according to DSA results .Patients showed no stenosis or mild stenosis were selected as control group ( 43 ca-ses),the other patients were divided into pure extracranial stenosis group (41 cases),simple intracranial stenosis group (93 cases) and extracranial stenosis group (47 cases).The results of laboratory test were analyzed .The ques-tionnaire was designed and the indicators including name ,age,long-term smoking,drinking,hypertension and diabetes were collected .Results Of all the subjects , there were 181 cases with artery stenosis .Single factor results showed that gender,age,long-term smoking,long-term drinking,hypertension,diabetes,high homocysteine,high level of lyso-phosphatidic acid were the independent risk factors of cerebral artery stenosis (χ2/t =8.744, 5.562, 10.736, 11.032,9.812,10.002,9.083,2.576,all P<0.05).Multivariate analysis showed that high homocysteine ,long-term smoking and drinking were the risk factors of simple intracranial artery stenosis .High homocysteine and high fibrino-gen were risk factors of simple extracranial stenosis .Age,hypertension,long-term smoking and drinking ,high homocys-teine and fibrinogen were risk factors of intracranial and extracranial stenosis .Conclusion In patients with ischemic cerebrovascular diseases ,the simple intracranial artery stenosis is most common .The incidence of cerebral artery ste-nosis has age characteristic ,with the increase of age ,the incidence rate of intracranial and extracranial artery stenosis is rising.High homocysteine,long-term smoking and drinking,hypertension,diabetes,high lysophosphatidic acid are independent risk factors of cerebral artery stenosis .

Objective To evaluate the curative effect and complications of percutaneous puncture kyphoplasty in the treatment of vertebral compression fracture in the elderly. Methods 19 cases of vertebral compression fracture in the elderly patients with disc 25 PKP technology applications were diagnosed with the accurate positioning,local anesthesia a small incision of about 0. 3cm later puncture path through vertebral pedicle to the wound vertebra,After perspective is the accurate lateral, putting into high-pressure balloon, injecting the contrast agent into the balloon with high-pressure syringe gradually. The wound vertebra is blackmai until a high degree of vertebral distraction to the recovery basis under the C-arm, and then taking the balloon out after pumping the contrast agent out. Bone cement is mixed well and injected into the cavity of the wound vertebra slowly which is the result of balloon dilation,during that time under the control of bone cement inside the wound vertebra,then puting the working column out and surgery completed. Results The low back pain of 19 patients immediately disappeared or significantly reduced after the operation, and 8 postoperative patients is up that day, 11 cases is up the following day. The degree of the wound vertebra is recovered by X-ray examination, and the bone cement evenly distributed within the wound vertebra, no spills. This group of patients are followed up for an average of 18 months(1 ～24 months) ,using visual analog and digital method to determine changes in Iow back pain. The data are paired t test,P ＜ 0.01. It have significant difference of views.Conclusion Percutaneous kyphoplasty accurate cervical disc herniation and effective disarmament of the symptoms and signs, with trauma and rapid recovery, fewer complications, shorter course of treatment and so on, and it is a safe and effective way in the treatment of vertebral compression fracture in the elderly.

Objective To evaluate the variation of the blood flow in anterolateral femoral head by ligating different amount of extracapsular arteries. Methods Thirty six hips of 18 mongrel puppies were divided into A、 B、 C、 D and E groups. In group A, only one peripheral artery was ligated randomly. In groups B, C, D,and E, 2, 3, 4, and 5 peripheral arteries were respectively ligated. The blood flow in anterolateral femoral head in 18 mongrel puppies was measured before and after the ligation of the arteries by using of Hydrogen clearance technique. Results 1) The average blood flow in anterolateral femoral head was (0.1397?0.0515) ml?min-1?ml-1. 2) The mean blood flow in the anterolateral femoral head was slightly decreased after one to two of the extracapsular main arteries were ligated but there was no statistical difference. However, the mean blood flow was decreased significantly after more than three arteries were ligated. Conclusion 1) Hydrogen clearance technique is a quite simple, economic and reliable method for estimation of blood flow perfusion in various tissue. 2) The efficiency of blood supply of the anterolateral femoral head in puppies depends at least upon three of the major extracapsular arteries.

Object To study the condition of Wenpi Decoction (WPD) with being decocted first and later added medicinal materials. Methods Contents of aconitine and free anthraquinone in WPD were determined by HPCE. Results Aconitine could reach the safe limit after Radix Aconiti Preparata being decocted 30 min first and the content of free anthraquinone was the highest after Radix et Rhizomea Rhei being decocted 10 min later. Conclusion Radix Aconiti Preparata should be decocted first and Radix et Rhizomea Rhei should be decocted later in WPD.