Infective endocarditis (IE) is a life-threatening infectious disease. Although histopathological examination remains the gold standard for definitive diagnosis, it is performed in only a minority of patients; thus, the diagnosis of IE continues to rely predominantly on clinical manifestations. However, IE presents with highly variable systemic symptoms that often lack cardiac-specific features, posing significant diagnostic challenges. To address this complexity, multiple diagnostic criteria have been developed, integrating clinical presentation, imaging findings, and microbiological evidence. Over the past three decades, substantial shifts in the microbiological and epidemiological profiles of IE, coupled with advances in imaging modalities and laboratory diagnostics, have profoundly influenced diagnostic approaches, driving continuous refinement of diagnostic criteria. This review provides a comprehensive overview of the major diagnostic criteria for IE, traces their historical evolution, evaluates recent updates and diagnostic performance, and offers theoretical insights and practical implications to guide future research.

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 summarize the clinical features of infectious intracranial aneurysm (IIA) related to infective endocarditis (IE) and share our experiences in the diagnosis and treatment of IIA. Methods A retrospective analysis was conducted on the clinical data of 554 patients who underwent cardiac surgery for IE at the Department of Cardiac Surgery, Guangdong Provincial People's Hospital from September 2018 to August 2023. Patients with secondary IIA were included and reviewed. Based on the treatment strategies, patients were stratified into two groups: an antibiotic-only group and an endovascular treatment group. Results The cohort comprised 21 males and 10 females, with a median age of 33 years (IQR 26-53). Fifteen (48.4%) patients showed no significant neurological symptoms before IIA diagnosis. Seven patients received antibiotic therapy alone, while 24 underwent additional endovascular embolization, achieving technical success in 23 (95.8%) patients. The median interval between endovascular embolization and cardiac surgery was 2 days (IQR 0-6), with 9 patients undergoing concurrent procedures. In the antibiotic-only group, 3 (42.9%) patients suffered fatal IIA rupture. In contrast, only 1 (4.2%) death due to aneurysm rupture occurred in the endovascular treatment group. All surviving patients recovered well without new neurological deficits. Conclusion Routine neuroimaging screening for IIA is critical in IE patients. For those requiring cardiac surgery, endovascular embolization combined with antimicrobial therapy represents a reasonable strategy to mitigate rupture risks and improve outcomes.

Objective To compare the clinical outcomes of mitral valvuloplasty (MVP) and mitral valve replacement (MVR) for infective endocarditis, and to investigate the effect of MVP under different surgical risks. Methods A retrospective study was done on the patients with mitral infective endocarditis, who underwent surgical treatment in our department from January 2018 to March 2022. According to the procedures, the patients were divided into a MVP group and a MVR group. Propensity score matching method was applied with a ratio of 1:1 to eliminate the biases. The early and midterm outcomes were compared between the two groups after matching. According to the European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE-Ⅱ), the effect of MVP was compared between high and low risk patients. Results A total of 195 patients were collected. There were 141 patients in the MVP group (120 males, 85.1%) and 54 patients in the MVR group (41 males, 75.9%). The mean follow-up time was (34.0±16.1) months. Patients in the MVP group were younger [(42.7±14.6) years vs. (56.8±13.0) years, P<0.001] and had better preoperative conditions. The patients in the MVP group had a shorter ICU stay [3.0 (2.0, 5.0) d vs. 4.0 (3.0, 8.0) d, P=0.004], and lower incidences of low cardiac output syndrome (0.7% vs. 9.3%, P=0.007), in-hospital mortality (0.0% vs. 3.7%, P=0.023), and follow-up mortality (4.3% vs. 15.4%, P=0.007). However, after 1:1 propensity score matching, there were no statistical differences in the baseline data or postoperative and follow-up adverse events between the two groups (P>0.05). Also, there was no statistical difference in the mortality of high-risk patients between MVP and MVR group (P>0.05). There was no statistical difference in the reoperation or recurrent severe mitral regurgitation between high and low-risk patients in the MVP group (P>0.05). Conclusion MVP is feasible for treating mitral lesions caused by infective endocarditis with good early and midterm outcomes. For patients with severer preoperative conditions, if the leaflet damage is not severe, MVP may be a viable option, but validation with larger sample sizes is needed.

Objective To explore the association between oral microbiota and esophageal carcinogenesis. Methods A case-control study design was employed. A total of 309 subjects were recruited, consisting of 159 healthy controls, 32 cases of esophageal basal cell hyperplasia, 32 cases of low-grade intraepithelial neoplasia, 14 cases of high-grade intraepithelial neoplasia, and 72 cases of esophageal squamous cell carcinoma. Tongue swab samples were collected for 16S rRNA sequencing. The α-diversity and β-diversity of the microbiota were analyzed, and the characteristics of the microbial communities at different stages of esophageal carcinogenesis were compared. The strength of the association was expressed by odds ratio (OR) and 95% confidence interval (CI). Results α-diversity analysis indicated significant differences in the observed species number (Sobs) index across various stages of esophageal cancer progression (P<0.001). After adjusting for confounding factors such as age, gender, smoking, and alcohol consumption, the Simpson index was positively correlated with carcinogenesis (P=0.006). β-diversity analysis revealed differences in microbiota structure among the groups. After ordered multinomial logistic regression analysis and adjustment for multiple confounding factors, the relative abundance of Peptostreptococcus (OR: 2.06, 95%CI: 1.22–3.60), Patescibacteria (OR: 1.31, 95%CI: 1.04–1.67), Capnocytophaga (OR: 1.24, 95%CI: 1.05–1.54), and Bacteroidota (OR: 1.02, 95%CI: 1.00–1.05) was positively correlated with carcinogenesis. The relative abundance of Stomatobaculum (OR: 0.57, 95%CI: 0.30–1.00) and Actinobacteriota (OR: 0.95, 95%CI: 0.92–0.98) was negatively correlated with carcinogenesis. Conclusion Specific oral microbiotas are significantly associated with esophageal carcinogenesis, and synergistic or antagonistic interactions may be observed among the microbiota.

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.