Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Objective:To evaluate the efficacy and safety of spesolimab in the treatment of generalized pustular psoriasis (GPP) .Methods:Six patients with GPP were retrospectively collected from Nanjing Drum Tower Hospital from February 2024 to April 2024, including 2 males and 4 females, aged 16 - 50 years. Four patients had a history of plaque psoriasis. Before treatment, the GPP Area and Severity Index (GPPASI) scores of the patients ranged from 24.6 to 60.8 points, and their GPP Physician Global Assessment (GPPGA) scores ranged from 2 to 4 points. All the 6 patients were intravenously injected with a single dose of 900 mg of spesolimab. Their GPPASI and GPPGA scores were recorded at weeks 1, 4, and 12, and adverse reactions were monitored during the treatment and follow-up.Results:Twenty-four hours after treatment, pustules were markedly reduced in the 6 patients with GPP; at week 1, pustules completely subsided, but erythema persisted; at week 4, both GPPASI and GPPGA scores decreased to 0 points; at week 12, no recurrence was observed. The patients with comorbid hypertension (4 cases), diabetes (1 case), or kidney disease (2 cases) maintained stable pressure or blood glucose levels, or showed improved renal function during the treatment and follow-up. Two patients experienced a transient fever after the treatment with spesolimab, resolving spontaneously after 2 days; two other patients exhibited exacerbation of plaque psoriasis. During the 12-week follow-up, none of the 6 patients experienced serious adverse reactions such as infections.Conclusion:In this study, spesolimab demonstrated rapid-onset efficacy and favorable safety in the treatment of GPP; conventional-dose spesolimab seemed safe for GPP patients with kidney disease.

Over the past three decades， China has made significant progress in the prevention and control of viral hepatitis， and the incidence rates of new-onset pediatric hepatitis B virus infections and acute viral hepatitis in the population have reduced to a relatively low level； however， there is still a heavy disease burden of chronic viral hepatitis in China， which severely affects the health status of the population. This study systematically summarizes the achievements of viral hepatitis prevention and control in China， analyzes existing problems and challenges， and proposes comprehensive prevention and control strategies and measures to eliminate viral hepatitis as a public health threat based on the national conditions of China， in order to provide a reference for related departments in China on how to achieve the action targets for eliminating viral hepatitis as a public health threat by 2030.

Objective To explore the current status of minor children parenting concerns among young and middle-aged breast cancer patients and investigate the influencing factors based on a random forest model so as to provide references for clinical interventions.Methods A convenience sampling method was used to select breast cancer patients undergoing treatment in our hospital between April and December 2023.A self-designed general information questionnaire,the Chinese version of parenting concerns questionnaire(PCQ),perceived social support scale(PSSS),concern about recurrence scale(CARS),and the brief illness perception questionnaire(BIPQ)were used for the study.A random forest model and the least absolute shrinkage and selection operator(LASSO)were employed to prioritise variables and filtered by significance.The selected variables were then incorporated into the multiple linear regression analysis.Results A total of 260 patients completed the study.The score of minor children parenting concerns of young and middle-aged breast cancer patients was 51.1±6.4.The multiple linear regression analysis,which included variables determined by random forest and LASSO regression(and sorted by the importance of influencing factors),showed that higher disease perception,lower perceived social support,greater concern about cancer recurrence,stage IV tumors,being divorced/widowed,and having more minor children were associated with higher parenting concerns among young and middle-aged breast cancer patients(all P<0.05),accounting for 57.0%of the total variance.Conclusion The minor children parenting concerns in young and middle-aged breast cancer patients are at a moderately high level and are influenced by a variety of factors.Healthcare professionals should develop targeted measures and interventions to reduce the parenting concerns among the patients.

Objective To explore the protective effect and mechanism of miR-202-5p on acute respiratory distress syndrome(ARDS)-induced lung injury in neonatal rats.Methods Sixty newborn SD rats were randomly divided into six groups:the control group(intraperi-toneal injection of normal saline by tail vein),ARDS group(ARDS model established via intraperitoneal injection of 4 mg/kg lipopolysac-charide by tail vein),ARDS+miR-NC group(ARDS rats receiving 2 mg/kg miR-NC via tail vein injection once every 4 h,with intervention for 12 h),ARDS+miR-202-5p group(ARDS rats receiving 2 mg/kg miR-202-5p via tail vein injection once every 4 h,with intervention for 12 h),ARDS+miR-202-5p+ov-NC group,and ARDS+miR-202-5p+ov-ROCK1 group(ARDS rats receiving 2 mg/kg miR-202-5p once every 4 h,with intervention for 12 h;with 6 × 108 plaque-forming units control or overexpression ROCK adenovirus administered via tail vein 3 days before lipopolysaccharide injection).Real-time quantitative PCR was employed to measure miR-202-5p and ROCK1 mRNA expression in rat lung tissue.Hematoxylin and eosin staining was performed to assess pathological lung injury.The lung tissue wet-to-dry weight ratio was determined to evaluate pulmonary edema.Western blotting was utilized to analyze ROCK1,Toll-like receptor 4(TLR4),phosphorylated-nuclear factor κB(p-NF-κB)p65,and phosphorylated-inhibitor of nuclear factor-κBα(p-IκBα)protein expression in lung tissue.The interaction between miR-202-5p and ROCK1 was validated using dual-luciferase reporter gene experiments.Results miR-202-5p expression was significantly down-regulated in ARDS rat lung tissue,while overexpression of miR-202-5p ameliorated pathological injury and pulmonary edema in ARDS rats.ROCK1 mRNA was upregulated in ARDS rat lung tissue;however,overexpression of miR-202-5p decreased the expression of ROCK1 in lung tissue of ARDS rats,while overexpression of ROCK1 reversed the protective effect of overexpression of miR-202-5p on lung injury in ARDS rats.Furthermore,miR-202-5p overexpression suppressed TLR4,p-NF-κB p65,and p-IκBα protein expression in ARDS rat lung tissue,an effect that was reversed by ROCK1 overexpression.Dual-luciferase reporter gene experiments confirmed that miR-202-5p directly targets ROCK1 mRNA 3'UTR.Conclusion miR-202-5p ameliorates ARDS-in-duced lung injury in neonatal rats through targeted suppression of ROCK1 expression,with the underlying mechanism potentially involving inhibition of ROCK1-mediated TLR4/NF-κB signaling pathway activation.

Objective:To evaluate the efficacy and safety of spesolimab in the treatment of generalized pustular psoriasis (GPP) .Methods:Six patients with GPP were retrospectively collected from Nanjing Drum Tower Hospital from February 2024 to April 2024, including 2 males and 4 females, aged 16 - 50 years. Four patients had a history of plaque psoriasis. Before treatment, the GPP Area and Severity Index (GPPASI) scores of the patients ranged from 24.6 to 60.8 points, and their GPP Physician Global Assessment (GPPGA) scores ranged from 2 to 4 points. All the 6 patients were intravenously injected with a single dose of 900 mg of spesolimab. Their GPPASI and GPPGA scores were recorded at weeks 1, 4, and 12, and adverse reactions were monitored during the treatment and follow-up.Results:Twenty-four hours after treatment, pustules were markedly reduced in the 6 patients with GPP; at week 1, pustules completely subsided, but erythema persisted; at week 4, both GPPASI and GPPGA scores decreased to 0 points; at week 12, no recurrence was observed. The patients with comorbid hypertension (4 cases), diabetes (1 case), or kidney disease (2 cases) maintained stable pressure or blood glucose levels, or showed improved renal function during the treatment and follow-up. Two patients experienced a transient fever after the treatment with spesolimab, resolving spontaneously after 2 days; two other patients exhibited exacerbation of plaque psoriasis. During the 12-week follow-up, none of the 6 patients experienced serious adverse reactions such as infections.Conclusion:In this study, spesolimab demonstrated rapid-onset efficacy and favorable safety in the treatment of GPP; conventional-dose spesolimab seemed safe for GPP patients with kidney disease.

Objective To explore the current status of minor children parenting concerns among young and middle-aged breast cancer patients and investigate the influencing factors based on a random forest model so as to provide references for clinical interventions.Methods A convenience sampling method was used to select breast cancer patients undergoing treatment in our hospital between April and December 2023.A self-designed general information questionnaire,the Chinese version of parenting concerns questionnaire(PCQ),perceived social support scale(PSSS),concern about recurrence scale(CARS),and the brief illness perception questionnaire(BIPQ)were used for the study.A random forest model and the least absolute shrinkage and selection operator(LASSO)were employed to prioritise variables and filtered by significance.The selected variables were then incorporated into the multiple linear regression analysis.Results A total of 260 patients completed the study.The score of minor children parenting concerns of young and middle-aged breast cancer patients was 51.1±6.4.The multiple linear regression analysis,which included variables determined by random forest and LASSO regression(and sorted by the importance of influencing factors),showed that higher disease perception,lower perceived social support,greater concern about cancer recurrence,stage IV tumors,being divorced/widowed,and having more minor children were associated with higher parenting concerns among young and middle-aged breast cancer patients(all P<0.05),accounting for 57.0%of the total variance.Conclusion The minor children parenting concerns in young and middle-aged breast cancer patients are at a moderately high level and are influenced by a variety of factors.Healthcare professionals should develop targeted measures and interventions to reduce the parenting concerns among the patients.

Objective To explore the protective effect and mechanism of miR-202-5p on acute respiratory distress syndrome(ARDS)-induced lung injury in neonatal rats.Methods Sixty newborn SD rats were randomly divided into six groups:the control group(intraperi-toneal injection of normal saline by tail vein),ARDS group(ARDS model established via intraperitoneal injection of 4 mg/kg lipopolysac-charide by tail vein),ARDS+miR-NC group(ARDS rats receiving 2 mg/kg miR-NC via tail vein injection once every 4 h,with intervention for 12 h),ARDS+miR-202-5p group(ARDS rats receiving 2 mg/kg miR-202-5p via tail vein injection once every 4 h,with intervention for 12 h),ARDS+miR-202-5p+ov-NC group,and ARDS+miR-202-5p+ov-ROCK1 group(ARDS rats receiving 2 mg/kg miR-202-5p once every 4 h,with intervention for 12 h;with 6 × 108 plaque-forming units control or overexpression ROCK adenovirus administered via tail vein 3 days before lipopolysaccharide injection).Real-time quantitative PCR was employed to measure miR-202-5p and ROCK1 mRNA expression in rat lung tissue.Hematoxylin and eosin staining was performed to assess pathological lung injury.The lung tissue wet-to-dry weight ratio was determined to evaluate pulmonary edema.Western blotting was utilized to analyze ROCK1,Toll-like receptor 4(TLR4),phosphorylated-nuclear factor κB(p-NF-κB)p65,and phosphorylated-inhibitor of nuclear factor-κBα(p-IκBα)protein expression in lung tissue.The interaction between miR-202-5p and ROCK1 was validated using dual-luciferase reporter gene experiments.Results miR-202-5p expression was significantly down-regulated in ARDS rat lung tissue,while overexpression of miR-202-5p ameliorated pathological injury and pulmonary edema in ARDS rats.ROCK1 mRNA was upregulated in ARDS rat lung tissue;however,overexpression of miR-202-5p decreased the expression of ROCK1 in lung tissue of ARDS rats,while overexpression of ROCK1 reversed the protective effect of overexpression of miR-202-5p on lung injury in ARDS rats.Furthermore,miR-202-5p overexpression suppressed TLR4,p-NF-κB p65,and p-IκBα protein expression in ARDS rat lung tissue,an effect that was reversed by ROCK1 overexpression.Dual-luciferase reporter gene experiments confirmed that miR-202-5p directly targets ROCK1 mRNA 3'UTR.Conclusion miR-202-5p ameliorates ARDS-in-duced lung injury in neonatal rats through targeted suppression of ROCK1 expression,with the underlying mechanism potentially involving inhibition of ROCK1-mediated TLR4/NF-κB signaling pathway activation.

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Objective To investigate the therapeutic effectiveness of ozone combined with low-temperature plasma coagulation therapy on patients with cervical spondylotic radiculopathy and its influence on inflammatory responses.Methods Ozone in combination with low-temperature plasma radio-frequency coagulation was applied to 75 patients with cervical spondylotic radiculopathy in Pain Medicine Department of Capital Medical University Affiliated Beijing Anzhen Hospital from May 2022 to May 2023.Pain scores were assessed using Visual Analog Scale(VAS)and Neck Disability Index(NDI)before and two weeks after treatment.Enzyme-linked immunosor-bent assay(ELISA)was used to analyze the level of tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6)and interferon-gamma(IFN-γ)before and two weeks after treatment.Results After treatment with ozone plus low-temperature plasma radiofrequency,VAS and NDI scores showed a significant decrease[VAS:5.36(4,7)vs.1.32(1,2),P＜0.000 1;NDI:32.72(24,70)vs.7.62(3.55,8.9),P＜0.000 1].Two weeks after surgical intervention,there was an effective reduction in the level of IL-6,TNF-αand IFN-γ alleviating the inflammatory re-sponse[IL-6:4.33(2.51,5.04)vs.3.49(2.08,4.43),P＜0.05;TNF-α:1.95(1.41,2.21)vs.1.61(1.02,2.03),P＜0.05;IFN-γ:1.84(1.18,2.47)vs.1.55(0.76,2.09),P＜0.05].Conclusions This Ozone combined with low-temperature plasma radiofrequency ablation is an effective technology for treatment of cer-vical spondylotic radiculopathy.