This study investigated the infection status,drug resistance,and molecular characteristics of Shiga toxin-producing Escherichia coli(STEC)in domestic goats in Chengkou county,Chongqing.In August 2023,283 fecal samples were collected from households in Chengkou county.After enrichment with EC broth and inoculation onto selective media,samples that tested positive for stx1/stx2 were selected for further isolation.The positive strains were investigated with antimicrobial susceptibility testing and whole genome sequencing.According to the whole genomic sequences,the stx subtypes,serotypes,multi-locus sequence types,virulence genes,drug resistance genes,and phylogenetic relationships of the STEC strains were analyzed.Forty-six strains of STEC were isolated from 283 goat fecal samples,thus resulting in a detection rate of 16.25%.The 46 STEC strains were categorized into 12 O∶H serotypes,among which O76∶H19 and O8∶H7 predominated,each represented by 9 strains.Five STEC strains were identified as serotype O157∶H7.The 46 STEC strains were categorized into 11 sequence types(STs),among which ST675 and ST196 predominated,each represented by nine strains,accounting for a 19.57%proportion.The strains were categorized into 7 stx subtypes,among which stx1c(26/46,56.52%),followed by stx2k(9/46,19.57%)predominated.All nine Stx2k-STEC strains were identified as serotype O8∶H7 and sequence type ST196.In antimicrobial susceptibility testing,2 STEC strains were resistant to ampicillin,one strain was resistant to ampicillin/sulbactam,one strain was resistant to cefazolin,and one strain was resistant to cefoxitin.Nine Stx2k-STEC strains were found to carry the beta-lactam resistance gene blaEC-18.Antimicrobial sensitivity tests revealed that the nine Stx2k-STEC strains were sensitive to all 15 tested antibiotics.Moreover,phylogenetic analysis indicated that the 9 Stx2k-STEC strains were remarkably similar but showed high genetic diversity with respect to that of the Stx2k-STEC strains isolated from other regions in China.Goatsare an important animal reservoir for STEC in theChengkou district of Chongqing,and novel sequence type Stx2k-STEC strains distinct from those found in other regions of China were identified in this region.

Objective:To analyze the clinical value of delayed solidification of cement at freezing point combined with establishment of cement channels in the treatment of further leakage of cement in percutaneous kyphoplasty (PKP).Methods:A retrospective analysis was performed for the medical records of 261 patients with osteoporotic vertebral fracture in the thoracolumbar segment who underwent PKP treatment in Beijing Puren Hospital from April 2019 to April 2023. According to the method of dealing with PKP cement leakage, it was divided into freezing point group (using bone cement combined with cement channel reconstruction treatment at freezing point temperature) and temperature gradient group (using temperature gradient method). There were 128 cases in the freezing point group, including 37 males and 91 females, aged 75.57±4.60 years (range, 65-85 years), and fracture locations were 18 cases in T 10, 30 cases in T 11, 44 cases in T 12, 23 cases in L 1 and 13 cases in L 2. There were 133 cases in the temperature gradient group, including 36 males and 97 females, aged 75.66±4.51 years (range, 65-85 years), and fracture locations were 17 cases in T 10, 32 cases in T 11, 51 cases in T 12, 22 cases in L 1, and 11 cases in L 2. The intraoperative blood loss, operation time, intravertebral cement area, cement leakage area, cement leakage area increase, cement bolus time and incidence of injection difficulty, as well as the pain visual analogue scale (VAS), Oswestry disability index (ODI), kyphosis angle, the height of the anterior edge of the injured vertebral body and the difference between it before and after surgery were compared. Results:All patients were followed up for 3 consecutive months. The intraoperative blood loss and initial cement leakage area were 9.48±2.64 ml and 32.56±7.05 mm 2 in the freezing point group and 9.04±2.25 ml and 32.86±7.00 mm 2 in the temperature gradient group, respectively, and the difference was not statistically significant ( P>0.05) ; The operation time, the area of bone cement in the vertebral body, the final leakage area of bone cement, and the increase of bone cement leakage in the freezing point group were 55.08±4.13 min, 1 175.45±117.11 mm 2, 35.84±8.67 mm 2, and 0.00(0.00, 13.32) mm 2, respectively, and the temperature gradient group were 53.02±3.96 min, 823.70±144.79 mm 2, and 73.38±29.16 mm 2 and 44.39(20.13, 56.61) mm 2, the differences were statistically significant ( P<0.05). The height of the anterior edge of the vertebral body was 21.54±2.06 mm and 21.24±2.33 mm immediately after surgery and 3 months after surgery in the freezing point group, which were higher than those in the temperature gradient group 21.10±1.60 mm and 18.92±1.51 mm, respectively, and the difference was statistically significant ( P<0.05). The VAS scores of the freezing point group were 2.29±0.62 and 1.03±0.66 points, ODI were 23.20%±3.97%, 10.43%±4.33%, and the kyphosis angles were 9.09°±2.80° and 9.44°±2.93°, respectively, which were lower than those of the temperature gradient group (4.11±0.79 and 2.79±0.65 points), ODI (35.97%±6.42%, and 23.73%±5.72%), and the kyphosis angles (10.24°±2.33° and 13.22°±2.56°), the differences were statistically significant ( P<0.05). The operating time of bone cement in the freezing point group was 10.89±2.35 min, which was longer than that in the temperature gradient group 5.77±0.52 min, and the difference was statistically significant ( t=24.021, P<0.001). The incidence of cement injection difficulty was 0 in the freezing point group and 27.1% (36/133) in the temperature gradient group. Conclusion:The establishment of bone cement combined with bone cement channel at freezing point temperature can effectively prolong the bolus time of bone cement and reduce the re-leakage of bone cement, which is conducive to increasing the injection volume and distribution area of bone cement in the vertebral body, effectively reducing the amount of bone cement leakage and obtaining better clinical efficacy.

AIM To investigate the variations in mercury dissolution from HgS-containing traditional medicines in three kinds of simulated gastrointestinal dissolution media.METHODS 39 batches of 15 types of HgS-containing traditional medicines were collected,total mercury content and dissolved mercury concentrations in simulated gastric fluid,simulated intestinal fluid,and L-cysteine-containing simulated intestinal fluid were measured.The maximum daily intake of total mercury and soluble mercury was calculated based on the maximum daily clinical dosage.RESULTS Among the 15 types of medicines,the maximum daily intake of total mercury varied by 156 times,the daily intake of soluble mercury varied by 3 502 times in simulated gastric fluid,313 times in simulated intestinal fluid,and 10 663 times in L-cysteine-containing simulated intestinal fluid,approximately.CONCLUSION For the 15 types of HgS-containing traditional medicines,the daily maximum intake of soluble mercury showed greater variations than that of total mercury.Soluble mercury concentration is more closely correlated with intestinal absorption of mercury and thus represents a more rational quality control indicator for HgS-containing traditional medicines.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To analyze the clinical value of delayed solidification of cement at freezing point combined with establishment of cement channels in the treatment of further leakage of cement in percutaneous kyphoplasty (PKP).Methods:A retrospective analysis was performed for the medical records of 261 patients with osteoporotic vertebral fracture in the thoracolumbar segment who underwent PKP treatment in Beijing Puren Hospital from April 2019 to April 2023. According to the method of dealing with PKP cement leakage, it was divided into freezing point group (using bone cement combined with cement channel reconstruction treatment at freezing point temperature) and temperature gradient group (using temperature gradient method). There were 128 cases in the freezing point group, including 37 males and 91 females, aged 75.57±4.60 years (range, 65-85 years), and fracture locations were 18 cases in T 10, 30 cases in T 11, 44 cases in T 12, 23 cases in L 1 and 13 cases in L 2. There were 133 cases in the temperature gradient group, including 36 males and 97 females, aged 75.66±4.51 years (range, 65-85 years), and fracture locations were 17 cases in T 10, 32 cases in T 11, 51 cases in T 12, 22 cases in L 1, and 11 cases in L 2. The intraoperative blood loss, operation time, intravertebral cement area, cement leakage area, cement leakage area increase, cement bolus time and incidence of injection difficulty, as well as the pain visual analogue scale (VAS), Oswestry disability index (ODI), kyphosis angle, the height of the anterior edge of the injured vertebral body and the difference between it before and after surgery were compared. Results:All patients were followed up for 3 consecutive months. The intraoperative blood loss and initial cement leakage area were 9.48±2.64 ml and 32.56±7.05 mm 2 in the freezing point group and 9.04±2.25 ml and 32.86±7.00 mm 2 in the temperature gradient group, respectively, and the difference was not statistically significant ( P>0.05) ; The operation time, the area of bone cement in the vertebral body, the final leakage area of bone cement, and the increase of bone cement leakage in the freezing point group were 55.08±4.13 min, 1 175.45±117.11 mm 2, 35.84±8.67 mm 2, and 0.00(0.00, 13.32) mm 2, respectively, and the temperature gradient group were 53.02±3.96 min, 823.70±144.79 mm 2, and 73.38±29.16 mm 2 and 44.39(20.13, 56.61) mm 2, the differences were statistically significant ( P<0.05). The height of the anterior edge of the vertebral body was 21.54±2.06 mm and 21.24±2.33 mm immediately after surgery and 3 months after surgery in the freezing point group, which were higher than those in the temperature gradient group 21.10±1.60 mm and 18.92±1.51 mm, respectively, and the difference was statistically significant ( P<0.05). The VAS scores of the freezing point group were 2.29±0.62 and 1.03±0.66 points, ODI were 23.20%±3.97%, 10.43%±4.33%, and the kyphosis angles were 9.09°±2.80° and 9.44°±2.93°, respectively, which were lower than those of the temperature gradient group (4.11±0.79 and 2.79±0.65 points), ODI (35.97%±6.42%, and 23.73%±5.72%), and the kyphosis angles (10.24°±2.33° and 13.22°±2.56°), the differences were statistically significant ( P<0.05). The operating time of bone cement in the freezing point group was 10.89±2.35 min, which was longer than that in the temperature gradient group 5.77±0.52 min, and the difference was statistically significant ( t=24.021, P<0.001). The incidence of cement injection difficulty was 0 in the freezing point group and 27.1% (36/133) in the temperature gradient group. Conclusion:The establishment of bone cement combined with bone cement channel at freezing point temperature can effectively prolong the bolus time of bone cement and reduce the re-leakage of bone cement, which is conducive to increasing the injection volume and distribution area of bone cement in the vertebral body, effectively reducing the amount of bone cement leakage and obtaining better clinical efficacy.

Aim To explore the mechanism of ligustil-ide(LIG)improving demyelination by inhibiting in-flammatory response in mice with distal middle cerebral artery occlusion(dMCAO)through AIM2/caspase-1 signal pathway.Methods Thirty C57BL/6N male mice were randomly divided into three groups:sham operation group(Sham group,n=10),model group(dMCAO group,n=10)and treatment group(LIG group,n=10).The dMCAO mouse model was estab-lished by electrocoagulation in dMCAO group and LIG group.The mice were scored by Longa after waking up,and the changes of cerebral blood flow were moni-tored by laser speckle blood flow imaging system after dMCAO.One hour after modeling,LIG(30 mg·kg-1·d-1)was injected intraperitoneally in LIG group,and the same amount of normal saline was injected in sham group and dMCAO group for one week until the end of the experiment.The mice in each group were stained with TTC,and the brain injury was observed pathologically.Fatigue turning bar test and open field test were used to evaluate the motor function and anxie-ty degree of mice,and then the brain tissues of mice were taken for black gold staining to compare the chan-ges of myelin sheath in each group.Immunofluores-cence staining was used to detect the average fluores-cence intensity of MBP,IBA1 and GFAP in CC,CPU and CX regions of mouse brains.ELISAwas used to de-tect the contents of TNF-α,IL-6,IL-1 β,IL-17A and BDNF in brain tissue proteins of mice.Western blot-ting was used to detect the protein expressions of AIM2,caspase-1 and ASC-in each group.Results Compared with the dMCAO group,the infarct area was reduced,the behavior was significantly improved and the demyelination was reduced in the LIG group.The expression of MBP protein in CC,CPU and CX regions increased(P＜0.05),the expression of IBA1 in CX decreased(P＜0.01),and the expression of GFAP in-creased in CC,CPU and CX regions(P＜0.01).The results of ELISA showed that the levels ofTNF-α(P＜0.01),IL-6(P＜0.01),IL-1β(P＜0.05)and IL-17A(P＜0.01)significantly decreased,while the ex-pression of BDNF increased(P＜0.05).The protein expression levels of AIM2,caspase-1 and ASC in mouse brain decreased after treatment(P＜0.01).Conclusion LIG has a protective effect on demyelina-tion in dMCAO mice,which may be related to the inhi-bition of AIM2/caspase-1 signaling pathway and in-flammation and to the promotion of BDNF secretion.

Aim To explore the mechanism of ligustil-ide(LIG)improving demyelination by inhibiting in-flammatory response in mice with distal middle cerebral artery occlusion(dMCAO)through AIM2/caspase-1 signal pathway.Methods Thirty C57BL/6N male mice were randomly divided into three groups:sham operation group(Sham group,n=10),model group(dMCAO group,n=10)and treatment group(LIG group,n=10).The dMCAO mouse model was estab-lished by electrocoagulation in dMCAO group and LIG group.The mice were scored by Longa after waking up,and the changes of cerebral blood flow were moni-tored by laser speckle blood flow imaging system after dMCAO.One hour after modeling,LIG(30 mg·kg-1·d-1)was injected intraperitoneally in LIG group,and the same amount of normal saline was injected in sham group and dMCAO group for one week until the end of the experiment.The mice in each group were stained with TTC,and the brain injury was observed pathologically.Fatigue turning bar test and open field test were used to evaluate the motor function and anxie-ty degree of mice,and then the brain tissues of mice were taken for black gold staining to compare the chan-ges of myelin sheath in each group.Immunofluores-cence staining was used to detect the average fluores-cence intensity of MBP,IBA1 and GFAP in CC,CPU and CX regions of mouse brains.ELISAwas used to de-tect the contents of TNF-α,IL-6,IL-1 β,IL-17A and BDNF in brain tissue proteins of mice.Western blot-ting was used to detect the protein expressions of AIM2,caspase-1 and ASC-in each group.Results Compared with the dMCAO group,the infarct area was reduced,the behavior was significantly improved and the demyelination was reduced in the LIG group.The expression of MBP protein in CC,CPU and CX regions increased(P＜0.05),the expression of IBA1 in CX decreased(P＜0.01),and the expression of GFAP in-creased in CC,CPU and CX regions(P＜0.01).The results of ELISA showed that the levels ofTNF-α(P＜0.01),IL-6(P＜0.01),IL-1β(P＜0.05)and IL-17A(P＜0.01)significantly decreased,while the ex-pression of BDNF increased(P＜0.05).The protein expression levels of AIM2,caspase-1 and ASC in mouse brain decreased after treatment(P＜0.01).Conclusion LIG has a protective effect on demyelina-tion in dMCAO mice,which may be related to the inhi-bition of AIM2/caspase-1 signaling pathway and in-flammation and to the promotion of BDNF secretion.