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.

Objective To explore the correlation between the expression of serum microRNA(miR)-1298-5p,miR-625-5p,and miR-155 with the degree of Helicobacter pylori(Hp)infection in elderly gastric cancer patients.Methods From January 2021 to November 2023,120 elderly patients with gastric cancer admitted to the hospital from January 2021 to November 2023 were selected as the gastric cancer group,and 130 non-gas-tric cancer patients who underwent gastroscopy were selected as the control group.The expression levels of miR-1298-5p,miR-625-5p and miR-155 in serum were detected by fluorescence quantitative PCR(qPCR).Car-bon 13 urea breath test was used to detect the positive rate of Hp infection in two groups,and the degree of Hp infection in elderly patients with gastric cancer were evaluated.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum miR-1298-5p,miR-625-5p,and miR-155 expression levels for Hp infection in elderly gastric cancer patients.Pearson method was applied to analyze the correlation between serum miR-1298-5p,miR-625-5p,miR-155 expression and positive rate of Hp infection in elderly gas-tric cancer patients.Results Compared with the control group,the expression levels of miR-1298-5p and miR-625-5p in serum of gastric cancer group decreased(P＜0.05),while the positive rate of Hp infection and the expression level of serum miR-155 increased(P＜0.05).The expression levels of serum miR-1298-5p and miR-625-5p in elderly gastric cancer patients with Hp grade Ⅰ,Ⅱ,and Ⅲ infection were lower than those without Hp infection,while the expression level of miR-155 was higher(P＜0.05).Patients with poor differ-entiation,lymph node metastasis,and TNM stage Ⅲ-Ⅳ had lower expressions of serum miR-1298-5p and miR-625-5p(P＜0.05),and higher expression of miR-155(P＜0.05)than those with moderate-high differen-tiation,no lymph node metastasis,and TNM stage Ⅰ-Ⅱ.The expression levels of serum miR-1298-5p and miR-625-5p were negatively correlated with the positive rate of Hp infection in elderly patients with gastric cancer(r=-0.443,-0.386,both P＜0.001),and the expression levels of serum miR-155 were positively correlated with the positive rate of Hp infection(r=0.525,P＜0.001).The area under the curve(AUC)of serum miR-1298-5p,miR-625-5p and miR-155 combined diagnosis of Hp infection in elderly gastric cancer pa-tients was higher than that of single diagnosis(P＜0.05).Conclusion The expression levels of miR-1298-5p and miR-625-5p in serum of elderly gastric cancer patients with Hp infection decrease,while the expression level of miR-155 increases.These three factors are related to the degree of Hp infection and have good diag-nostic value for the occurrence of Hp infection.

Objective To investigate the correlations of intelligence level and cognitive function with electroencephalogram abnormalities in children with Attention Deficit Hyperactivity Disorder(ADHD).Methods A total of 85 children with ADHD were enrolled as ADHD group,and another 82 healthy children who underwent physical examinations during the same period were selected as control group.Both groups underwent electroencephalogram examinations and were assessed for intel-ligence level and cognitive function using the Chinese-Wechsler Intelligence Scale for Children(C-WISC)and Wisconsin Card Sorting Test(WCST),respectively.Pearson correlation analysis was conducted to explore the correlations of the C-WISC and WCST assessment results with the probability of EEG abnormalities in children with ADHD.Results Children in the ADHD group exhibited high-er incidence of irregular α waves,increased β rhythm,increased θ waves,increased δ waves,epi-leptiform discharges,and a higher overall abnormal rate in electroencephalogram compared to those in the control group(P＜0.05).C-WISC assessment results showed that the Verbal Intelligence Quotient(VIQ),Performance Intelligence Quotient(PIQ),and Full-Scale Intelligence Quotient(FIQ)of children in the ADHD group were lower than those in the control group(P＜0.05).According to the electroencephalogram results,children with ADHD were further divided into abnormal group of 41 cases and normal group of 44 cases.The VIQ,PIQ,and FIQ of children in the abnormal group were lower than those in the normal group(P＜0.05).The WCST assessment results showed that the number of categories completed by children in the ADHD group was lower than that of the control group,while the number of error responses,perseverative errors,and perseverative responses were higher than those in the control group(P＜0.05).The VIQ,PIQ,FIQ,and number of categories completed in children with ADHD were negatively correlated with the probability of EEG abnormali-ties(r=-0.421,-0.462,-0.561,-0.403,P＜0.05).Conclusion Some children with ADHD exhibit electroencephalogram abnormalities,decreased intelligence levels,and impaired cog-nitive function,and the probability of electroencephalogram abnormalities is negatively correlated with the intelligence level and cognitive function of children with ADHD.

Botulinum toxin poisoning can lead to severe health crises, and multidisciplinary collaboration is crucial for rapid diagnosis and emergency treatment. This article reported a case of a 21-year-old female patient who developed symptoms of botulinum toxin poisoning 4 days after receiving botulinum toxin type A through an unofficial route. Significant symptomatic improvement was observed 9 days after the onset of poisoning following botulinum antitoxin treatment. Through a case report and a review of neurophysiological literature, the role of neurophysiological examinations in aiding diagnosis was analyzed, providing a scientific basis for clinical treatment..

AIM:By establishing ischemic stroke(IS)rats and cell models,this study aimed to investigate the therapeutic effect of an enriched environment(EE)and to explore its impact on the neurotrophin 3(NT3)/p75 neuro-trophin receptor(p75NTR)signaling pathway.METHODS:The study consisted of in vivo and in vitro experiments.In vi-vo,Sprague-Dawley(SD)rats were randomly divided by weight into sham,IS,and IS+EE groups(n=10),with 8 addi-tional rats per group reserved for supplementary analyses.The IS model was established by the Longa suture occlusion method.Neurological and motor function deficits were assessed on days 1,3,7 and 14 post-modeling using the modified neurological severity score(mNSS).On days 3,7 and 14,4 additional rats from each group were sacrificed,and the whole-brain tissue was collected to measure infarct volume via 2,3,5-triphenyltetrazolium chloride(TTC)staining.On day 14,brain tissue was harvested for immunofluorescence staining to evaluate neuronal proliferation markers,while the ischemic penumbra was analyzed by Western blot for NT3/p75NTR pathway protein expression.In vitro,primary neural stem cells(NSCs)were isolated from fetal rats and cultured as neurospheres.These cells were divided into CON group and experimental groups treated with different concentrations of NT3 to evaluate the effects of NT3 on NSC proliferation and migration.Additionally,SH-SY5Y cell lines were used to establish an in vitro model of ischemic stroke through oxy-gen-glucose deprivation(OGD).These cells were treated with varying concentrations of NT3,along with CON and CON+NT3 groups,and a scratch assay was performed to assess the impact of NT3 on cell migration.RESULTS:EE significant-ly reduced neurological function scores in IS rats(P<0.05),prolonged latency in the rotarod test(P<0.05),and de-creased cerebral infarct area(P<0.05).EE further enhanced the protein expression of BrdU and Ki67 in the ischemic penumbra(P<0.05),as well as increased the co-expression of BrdU/DCX and BrdU/NeuN(P<0.05).Additionally,EE further upregulated the protein expression of NT3,p75NTR,PI3K,and Akt in the subventricular zone(SVZ)(P<0.05).In vitro,NT3(1 and 10 μg/L)significantly increased nestin expression(P<0.05)in the primary neural stem cell system.In the neural stem cell sphere system,compared to the CON group,1 μg/L NT3 markedly enhanced tubulin and phalloidin protein expression(P<0.05).In the scratch assay,1 ug/L NT3 significantly promoted the migration of both normal SH-SY5Y cells and OGD-induced SH-SY5Y cells compared to the CON group(P<0.05).CONCLUSION:Enriched envi-ronment activates the NT3/p75NTR signaling pathway,promoting the proliferation of NSCs in the SVZ and their migration to the ischemic penumbra,where they ultimately differentiate into neurons to replace those damaged,thereby contributing to the improvement of neurological function in rats with IS.

AIM:By establishing ischemic stroke(IS)rats and cell models,this study aimed to investigate the therapeutic effect of an enriched environment(EE)and to explore its impact on the neurotrophin 3(NT3)/p75 neuro-trophin receptor(p75NTR)signaling pathway.METHODS:The study consisted of in vivo and in vitro experiments.In vi-vo,Sprague-Dawley(SD)rats were randomly divided by weight into sham,IS,and IS+EE groups(n=10),with 8 addi-tional rats per group reserved for supplementary analyses.The IS model was established by the Longa suture occlusion method.Neurological and motor function deficits were assessed on days 1,3,7 and 14 post-modeling using the modified neurological severity score(mNSS).On days 3,7 and 14,4 additional rats from each group were sacrificed,and the whole-brain tissue was collected to measure infarct volume via 2,3,5-triphenyltetrazolium chloride(TTC)staining.On day 14,brain tissue was harvested for immunofluorescence staining to evaluate neuronal proliferation markers,while the ischemic penumbra was analyzed by Western blot for NT3/p75NTR pathway protein expression.In vitro,primary neural stem cells(NSCs)were isolated from fetal rats and cultured as neurospheres.These cells were divided into CON group and experimental groups treated with different concentrations of NT3 to evaluate the effects of NT3 on NSC proliferation and migration.Additionally,SH-SY5Y cell lines were used to establish an in vitro model of ischemic stroke through oxy-gen-glucose deprivation(OGD).These cells were treated with varying concentrations of NT3,along with CON and CON+NT3 groups,and a scratch assay was performed to assess the impact of NT3 on cell migration.RESULTS:EE significant-ly reduced neurological function scores in IS rats(P<0.05),prolonged latency in the rotarod test(P<0.05),and de-creased cerebral infarct area(P<0.05).EE further enhanced the protein expression of BrdU and Ki67 in the ischemic penumbra(P<0.05),as well as increased the co-expression of BrdU/DCX and BrdU/NeuN(P<0.05).Additionally,EE further upregulated the protein expression of NT3,p75NTR,PI3K,and Akt in the subventricular zone(SVZ)(P<0.05).In vitro,NT3(1 and 10 μg/L)significantly increased nestin expression(P<0.05)in the primary neural stem cell system.In the neural stem cell sphere system,compared to the CON group,1 μg/L NT3 markedly enhanced tubulin and phalloidin protein expression(P<0.05).In the scratch assay,1 ug/L NT3 significantly promoted the migration of both normal SH-SY5Y cells and OGD-induced SH-SY5Y cells compared to the CON group(P<0.05).CONCLUSION:Enriched envi-ronment activates the NT3/p75NTR signaling pathway,promoting the proliferation of NSCs in the SVZ and their migration to the ischemic penumbra,where they ultimately differentiate into neurons to replace those damaged,thereby contributing to the improvement of neurological function in rats with IS.

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.