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.

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.

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.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Thyroid nodules are very common in the clinical practice. Fine needle aspiration ( FNA) is a major method for the final diagnosis of thyroid nodules. This review tried to cover the definition, current status, clinical significance, indications, contraindications, ultrasound evaluation, as well as preparations, steps, molecular diagnosis, cytology diagnosis, and possible pitfalls of this technique. Our purpose is trying to make this procedure universalized and standardized in order to serve more patients by providing clinicians with some helpful references and advice.

Nowadays, severe infection has become one of the common problems in clinic. The morbidity of severe sepsis and septic shock is increasing, which becomes a big threat to patients with burn wounds or chronic diseases. It has become a key subject about how to cure severe sepsis and septic shock. In recent years, mortality of patients in such condition has declined slightly, which might be attributed to the application of early goal-directed therapy (EGDT) in certain degree. This article reviews application of EGDT in severe sepsis and septic shock, in order to analyze its effectiveness and boundedness, as well as predict its development.
Humans ; Sepsis ; therapy ; Shock, Septic ; therapy

Objective To evaluate perioperative fluid infusion strategies in retroperitoneal tumor patients.Method Data of 89 retroperitoneal tumor patients in Peking University People's Hospital and Peking University International Hospital were collected and devided into intraoperative minor haemorrhage group (761 ml) and massive haemorrhage group (4 813 ml),including postoperative fluid treatment,input and output volume,serum brain natriuretic peptide level and postoperation complications.Results Fluid input on the 1st day after operation,the 2nd day,the 3rd day respectively were (7 565 ±4 757),(3 869 ± 727),(3 289 ± 897),(3 096 ± 567) ml in the minor haemorrhage group,and (13 927 ± 5 612),(5 192 ± 1 274),(3 786 ± 1 137),(3 797 ± 719) ml in the massive haemorrhage group (t =-4.637,-3.117,-2.460,-2.982,P =0.04,0.048,0.36,0.038).BNP level respectively were (33 ±25),(82 ±66),(116 ± 54),(145 ± 75) ng/ml in the minor haemorrhage;respectively,(70 ± 65),(165 ± 153),(256 ± 220),(442 ± 412) ng/ml in the massive haemorrhage group (t =-4.637,-3.117,-2.460,-2.982,P =0.041,0.038,0.046,0.04).The accumulative percentage of negative fluid balance was 100％ in 3 days after operation.Acute kidney injury (AKI),cardiac,respiratory events,major intraabdominal complications deep venous thrombosis developed in minor and massive haemorrhage group were 4.7％,7.1％,4.7％,14.3％,9.5％ vs.25.1％,27.6％,46.8％,10.6％,17.0％ respectively (x2 =2.89,5.89,19.96,0.044,0.674,P=0.049,0.015,0.001,0.834,0.412).Conclusions Multiple goals directed fluid strategy leads to a better outcome by decreasing the AKI rate.BNP level could be used as a goal marker in fluid treatment.

Objective To present some revision surgery for correcting short and bulky outward appearance of reconstructed finger pulp in toe-to-hand transfer. Methods Since Sep. 1998 to Dec. 2006,in a series of 33 patients, 39 fingers had been reconstructed with 2nd toe. In order to change the shape of bulbous distal toe segment into a normal tapering fingertip, revisional operations had been designed, i.e. (1)Excision of bulky skin and excessive soft tissue from one or both sides of the finger pulp. (2)Transfer and inlaid the excised lateral soft tissue flap to the central constricting part of the finger pulp. (3)Full thickness skin graft to palmar central narrow part of toe pulp. 4. Rotational transfer of local lateral "L" shape flap. Results All the patients healed by first intention with no skin necrosis occurred. The bulbous rectangular shaped toe pulp were corrected and outward appearance were much improved in most cases. Though the outward appearance in one simple skin graft case was not satisfactory in correcting flexion deformity of distal segment and increased its circumference. Conclusion In toe-to-hand transfer, the distal segment of reconstructed finger often shown to have an bulbous toe pulp appearance, which may bring psychological burden to the patient and their relatives. Simple revisional surgery recommended here may yield favorable improvement.