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.

Extensive epigenetic reprogramming involves in memory CD8+ T-cell differentiation. The elaborate epigenetic rewiring underlying the heterogeneous functional states of CD8+ T cells remains hidden. Here, we profile single-cell chromatin accessibility and map enhancer-promoter interactomes to characterize the differentiation trajectory of memory CD8+ T cells. We reveal that under distinct epigenetic regulations, the early activated CD8+ T cells divergently originated for short-lived effector and memory precursor effector cells. We also uncover a defined epigenetic rewiring leading to the conversion from effector memory to central memory cells during memory formation. Additionally, we illustrate chromatin regulatory mechanisms underlying long-lasting versus transient transcription regulation during memory differentiation. Finally, we confirm the essential roles of Sox4 and Nrf2 in developing memory precursor effector and effector memory cells, respectively, and validate cell state-specific enhancers in regulating Il7r using CRISPR-Cas9. Our data pave the way for understanding the mechanism underlying epigenetic memory formation in CD8+ T-cell differentiation.
CD8-Positive T-Lymphocytes/metabolism* ; Cell Differentiation ; Chromatin/immunology* ; Animals ; Mice ; Immunologic Memory ; Epigenesis, Genetic ; SOXC Transcription Factors/immunology* ; NF-E2-Related Factor 2/immunology* ; Mice, Inbred C57BL ; Gene Regulatory Networks ; Enhancer Elements, Genetic

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.

Abstract: It is well-known that crystal form of a drug is a key factor impacting the physicochemical properties of the drug, which in turn affects its in vivo efficacy, safety and stability. The study on crystal forms of solid-state drugs is crucial for drug quality control, selection of production process and evaluation of clinical efficacy. The combination of chemometric and analytical techniques exhibited its great ability to analyze a large amount of multidimensional data, providing the possibility for quantification of trace amount of crystals (< 1%). Meanwhile, using the process analytical technology (PAT) to monitor the crystal content real-time during prescription preparation process can further realize the control on formulation quality and serve as a core technology to support the patent protection of crystalline forms. In this review, the combined application of crystal analytical techniques and chemometric methods for the quantitative analysis of trace crystals were summarized, aiming to provide guidance for the manufacturing of pharmaceutical preparations and their quality control.

Objective To construct and validate a prediction model of residual shunt occurring after interventional closure of ventricular septal defect(VSD)in child patients,and to analyze the prognosis of the child patients with residual shunt.Methods A total of 178 child patients with VSD,who were admitted to the hospital to receive treatment from January 2017 to March 2023,were selected for this study.Adopting a 8:2 ratio,the child patients were randomly divided into the training set(n=144)and the validation set(n=34).Interventional closure of VSD was carried out in all the child patients.During the postoperative follow-up of 12 months,the occurrence of the residual shunt was recorded.The factors influencing the occurrence of residual shunt after interventional closure of VSD in child patients were analyzed.A prediction model for residual shunt after interventional closure of VSD in child patients was established and validated,and its efficacy was evaluated.The prognosis of the child patients having residual shunt was analyzed.Results Residual shunt occurred in 21 child patients(14.58％,21/144)in the training set and in 5 child patients(14.71％,5/34)in the validation set.Logistic regression analysis showed that the size of the base of VSD(OR=5.339,95％CI:2.197-12.975),pressure difference at the site of defect(OR=4.384,95％CI:1.804-10.655),and diameter of occluder(OR=4.707,95％CI:1.937-11.439)were the influencing factors for residual shunt occurring after interventional closure of VSD in child patients(P＜0.05).Taking the above influencing factors as the predictive variables,a nomogram prediction model was established.The verification results of the nomogram model showed that the C-index was 0.808(95％CI:0.761-0.839),and the correction curve for predicting residual shunt after interventional closure of VSD in child patients was close to the ideal curve(P＞0.05).ROC curve analysis of the training set indicated that the sensitivity,specificity and AUC of the nomogram model for predicting residual shunt after interventional closure of VSD in child patients were 80.95％,84.55％and 0.855(95％CI:0.774-0.937)respectively.ROC curve analysis of the validation set revealed that the sensitivity,specificity and AUC of the nomogram model for predicting residual shunt after interventional closure of VSD in child patients were 80.00％,86.21％and 0.871(95％CI:0.791-0.943)respectively.In the training set,21 child patients developed residual shunt,and in 14(66.67％)of them the residual shunt was healed spontaneously.The proportion of patients with a residual shunt size＞4mm in the residual shunt self-healing group was lower than that in the residual shunt no-healing group(P＜0.05).Conclusion The size of the base of VSD,the pressure difference at the site of defect,and the diameter of the occluder are the factors that affect the occurrence of residual shunt after interventional closure of VSD in child patients.The prediction model constructed on the above predictors has excellent efficacy in predicting the occurrence of residual shunt after interventional closure of VSD in child patients.In most child patients whose residual shunt size is＜4 mm,the residual shunt can heal spontaneously.

Objective The purpose of this study is to compare the wear properties of UHMWPE acetabular liners after undergoing 3 million(3 Mc)and 5 million(5 Mc)cycles of in-vitro wear testing.The results will serve as a reference for the design of in-vitro testing for hip prostheses and as a control for clinical revision removals.Methods Wear tests were conducted on three different sizes of acetabular liners(28 mm,32 mm,and 36 mm internal diameters)using a hip simulator to determine the amount of wear after 3 and 5 million cycles.The analysis included the number,size,and shape of abrasive particles.Results After 3 and 5 million cycles of wear,the amount of wear on the acetabular liner increased as the inner diameter increased.The abrasive particles had an average equivalent circular area diameter(ECD)of 0.27 μm and 0.29 μm,and 94.4%and 90.1%of the aspect ratio(AR)less than 4.Conclusion The amount of wear on the acetabular liner after 3 Mc wear can indicate the wear performance of the product.The number of particles increased and the percentage of fibrous particles was higher after 5 Mc wear compared to 3 Mc wear.

Public hospitals bear the responsibility of ensuring people's health and promoting their healthy lives.New media have emerged as a pivotal platform for health science popularization in public hospitals.Under these contexts,the Science Popularization Base for Health and Chronic Disease Prevention of the First Hospital of Lanzhou University established a multidisci-plinary team model for science popularization,mainly relying on the WeChat official account to disseminate health knowledge and dispel rumors.This article explored the experiences and practices of health science popularization under this model,focusing on the"meticulous selection for science popularization"strategy employed on their WeChat official account.

Objective To analyze coating properties of porous artificial joints,including coating morphology and coating mechanical properties,and summarize the range of coating properties of current mainstream products,to provide references for the design and development of new products,as well as provide the basis for the long-term implant removal analysis.Methods Samples for the surface morphology,shear strength,and tensile strength of the coatings used in the experiment were prepared in accordance with ASTM F1854,ASTM F1044,and ASTM F1 147 standards,respectively.The coatings were processed using plasma spraying.The surface morphology(coating thickness,porosity,and pore intercept)of the coatings for all 17 products(Nos.1-17)was tested;for products Nos.1-7 and Nos.15-16,the shear strength test between the coating and substrate was conducted first in accordance with the test method of ASTM F1044.Then,according to the test method of ASTM F1 147,the tensile strength test between the coating and substrate was conducted.For product No.17,the shear and tensile strengths of the composite coating and simple titanium coating were tested,respectively,according to the test method of ASTM F1044 and ASTM F1 147.Results A total of 15 products(88.2％)had coating thicknesses between 300 μm and 500 μm.There were 16 metal-coated products(Nos.1-16),of which 11(68.75％of the total)had coating porosities between 30％and 50％,and 14(87.5％of the total)had coating pore intercepts between 50 μm and 150 μm.The mechanical properties of the coatings were independent of the substrate material used.The shear and tensile strengths of the composite coatings with hydroxyaptite(HA)were significantly lower than those of the pure metal coatings.Conclusions For the design and manufacture of artificial joints with porous coatings,the performance of the coating can be referred to the following indexes:the coating thickness is 300-500 μm,the coating porosity is 30％-50％,the coating pore intercept is 50-150 μm.The substrate materials can be selected based on the use of the product.The effects of a lower bonding force on product performance should be considered when designing prostheses with composite coatings containing HA.This range of performance metrics provides control for long-term clinical extraction analyses.