BACKGROUND:Traditional surgery for lumbar disc herniation involves extensive excision of tissue surrounding the nerve for decompression and removal of protruding lumbar intervertebral discs,which poses various risks and complications such as nerve damage causing paralysis,lumbar instability,herniation recurrence,intervertebral space infection,and adjacent vertebral diseases. OBJECTIVE:To propose the symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous technique for lumbar spine symmetrically decompression,showing the induced resorption of herniated nucleus pulpous phenomenon and early clinical efficacy,and then analyze its decompression mechanism. METHODS:214 patients with lumbar disc herniation at Department of Orthopedics,First Affiliated Hospital of Zhengzhou University from March 2021 to May 2023 were enrolled in this study.Among them,81 patients received conservative treatment as the control group,and 133 patients received symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous treatment as the trial group.Before surgery,immediately after surgery(7-14 days),and early after surgery(over 1 year),MRI images were used to measure the volume changes of lumbar disc herniation.CT images were used to measure the posterior displacement distance of the lumbar spinous process ligament complex,as well as the width and height of the lateral recess.Japanese Orthopaedic Association scores were used to evaluate the patient's neurological function recovery. RESULTS AND CONCLUSION:(1)Control group:81 patients with lumbar disc herniation were treated conservatively,with a total of 171 herniated lumbar discs.The average follow-up time was(22.7±23.1)months.The first and second MRI measurements of 171 herniated lumbar discs showed herniated lumbar disc volumes of(551.6±257.9)mm3 and(792.2±330.4)mm3,respectively,with an average volume increase rate of(53.2±44.4)%,showing statistically significant differences(P<0.001).Out of 171 herniated lumbar discs,4 experienced natural shrinkage,with an absorption ratio of 2.3%(4/171)and an absorption rate of(24.5±9.9)%.(2)Trial group:133 patients with lumbar disc herniation had a total of 285 herniated lumbar discs.(1)Immediately after surgery:All patients were followed up immediately after surgery.229 out of 285 herniated lumbar discs experienced retraction,with an absorption ratio of 80.3%(229/285)and an average absorption rate of(21.5±20.9)%,with significant and complete absorption accounting for 6.5%.There were a total of 70 herniated lumbar discs in the upper lumbar spine,with an absorption ratio of 85.7%(60/70),an average absorption rate of(23.1±19.5)%,and a maximum absorption rate of 86.6%.There were 215 herniated lumbar discs in the lower lumbar spine,with an absorption ratio of 78.6%(169/215),an average absorption rate of(21.0±21.3)%,and a maximum absorption rate of 83.2%.Significant and complete absorption of the upper and lower lumbar vertebrae accounted for 5.7%and 6.5%,respectively,with no statistically significant difference(P>0.05).The average distance of posterior displacement of the spinous process ligament complex immediately after surgery was(5.2±2.8)mm.There were no significant differences in the width and height of the left and right lateral recess before and immediately after surgery(P>0.05).The Japanese Orthopaedic Association score immediately after surgery increased from(10.1±3.4)before surgery to(17.0±4.8),and the immediate effective rate after surgery reached 95.6%.(2)Early postoperative period:Among them,46 patients completed the early postoperative follow-up.There were 101 herniated lumbar discs,with an absorption ratio of 94%(95/101)and an average absorption rate of(36.9±23.7)%.Significant and complete absorption accounted for 30.6%,with a maximum absorption rate of 100%.Out of 101 herniated lumbar discs,3 remained unchanged in volume,with a volume invariance rate of 2.97%(3/101).Out of 101 herniated lumbar discs,3 had an increased volume of herniated lumbar discs,with an increase ratio of 2.97%(3/101)and an increase rate of(18.5±18.4)%.The Japanese Orthopaedic Association score increased from preoperative(9.3±5.1)to(23.5±4.0),with an excellent and good rate of 93.4%.(3)The early postoperative lumbar disc herniation absorption ratios of the control group and trial group were 2.3%and 85.9%,respectively,with statistically significant differences(P<0.001).(4)Complications:There were two cases of incision exudation and delayed healing in the trial group.After conservative treatment such as dressing change,no nerve injury or death occurred in the incision healing,and no cases underwent a second surgery.(5)It is concluded that symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous is a new method for treating lumbar disc herniation that can avoid extensive excision of the"ring"nerve and achieve satisfactory early clinical efficacy.It does not damage the lumbar facet joints or alter the basic anatomical structure of the lateral recess,fully preserves the herniated lumbar discs,and can induce significant or even complete induced resorption of herniated nucleus pulpous.Symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous provides a new basis and method for the clinical treatment of lumbar disc herniation.

OBJECTIVE:Prolonged sedentary behavior can acutely reduce peripheral and central vascular function,thereby increasing the risk of cardiovascular disease.Interrupting sedentary behavior may be a potential practical strategy to prevent vascular dysfunction caused by prolonged sitting.However,current research findings on its acute effects are inconsistent,and specific application recommendations have not yet been established.This study aims to perform a Meta-analysis on the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults and to explore its regulatory factors.METHODS:Following PRISMA reporting guidelines,literature search was conducted in March 2024 using the keywords of"interrupting,""sedentary,"and"vascular function"in the Web of Science Core Collection,PubMed,and China National Knowledge Infrastructure(CNKI)databases.Acute randomized crossover trials addressing the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults were included.Risk of Bias 2 developed by Cochrane was used to assess bias risk,and the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system was used to evaluate the evidence level.The"meta"and"metaphor"packages in R(version 4.2.0)were used for main effect aggregation(Hedge's g acted as the effect size indicator),publication bias testing,subgroup analysis,and regression analysis.RESULTS:Twenty-two randomized crossover trials involving 364 subjects(aged 21 to 70 years)were included.Meta-analysis results showed that compared with prolonged sitting,interrupting sedentary behavior acutely improved peripheral vascular blood flow volume(Hedge's g=0.48,95%confidence interval:0.14-0.82,P<0.01,I2=63%,low evidence level),shear stress(Hedge's g=0.65,95%confidence interval:0.37-0.93],P<0.01,I2=54%,moderate evidence level),and flow-mediated dilation(Hedge's g=0.43,95%confidence interval:0.15-0.72,P<0.01,I2=61%,moderate evidence level).Disease had a significant moderating effect on the main effect aggregation for blood flow volume(P=0.01 between subgroups),while the mode(P=0.01 between subgroups)and frequency(P=0.02 between subgroups)of interruptions had significant moderating effects on shear stress.Improvements in peripheral vascular shear stress from interrupting sedentary behavior were affected by age(β=-0.02,95%confidence interval:-0.03-0.01,P=0.09)and body mass index(β=-0.10,95%confidence interval:-0.18 to-0.02,P<0.01).Improvements in flow-mediated dilation were influenced by the total number of interruptions(β=-0.09,95%confidence interval:-0.17 to-0.01,P=0.03)and the duration of sitting during the control period(β=-0.21,95%confidence interval:-0.34 to-0.09,P<0.01).Each additional hour of sitting was associated with a 0.67%reduction in the acute improvement effect of flow-mediated dilation from interrupting sedentary behavior(P<0.01),and acute benefits disappeared when sitting control time exceeded 6 hours.A qualitative systematic review found that interrupting sedentary behavior did not significantly affect pulse wave velocity in various populations but could effectively prevent central vascular function decline in older adults due to prolonged sitting.CONCLUSION:Interrupting sedentary behavior acutely improves peripheral vascular blood flow volume(low evidence level),shear stress(moderate evidence level),and flow-mediated dilation(moderate evidence level)in adults and may prevent or protect against central vascular function decline in older adults due to prolonged sitting(very low evidence level).Characteristics of subjects(disease factors,sex,age,and body mass index),interruption intervention schemes(mode,frequency,total number of interruptions),and duration of sitting control all influence the acute improvement effects of interrupting sedentary behavior on vascular function.It is recommended that adults interrupt sedentary behavior with exercises involving large muscle groups,such as stair climbing,at high frequencies(e.g.,once every 40 minutes)with at least 5 minutes of moderate-to low-intensity activity each time,and limit the cumulative duration of prolonged sitting to no more than 6 hours per day.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective::This study aimed to elucidate the effect of the lipopolysaccharides/toll-like receptor 4 (LPS/TLR4) pathway on early atherosclerosis (AS) development and its associated changes in fecal metabolites, thereby providing an experimental foundation for strategies to prevent and treat early AS.Methods::Twelve Tibetan miniature pigs aged 4-5 months were divided into normal control (NC) group and AS group (6 pigs in each). The group assignment was primarily based on body weight; Secondary criteria, including glucose, lipid profiles, and inflammatory indices, were considered to ensure balanced baseline characteristics between the 2 groups (all P > 0.05). AS group received a high-fat diet for 16 weeks to establish an AS model, while the NC group received a normal diet. Subsequently, serum levels of lipids and various inflammation and oxidative stress markers were measured. Pathological changes in the aorta and colon tissue, LPS/TLR4 pathway-associated protein expressions in the aorta, as well as occludin and zonula occludens-1 in the colon were also assessed. Proton nuclear magnetic resonance spectra technology was employed for the metabolomic analysis of fecal extracts. Results::The lipid metabolism was disrupted in AS group, with significantly higher total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels ((12.24 ± 5.24) mmol/L vs. (1.86 ± 0.27) mmol/L, P = 0.004,6; (2.39 ± 0.50) mmol/L vs. (0.83 ± 0.07) mmol/L, P = 0.000,5; (6.94 ± 2.87) mmol/L vs. (0.77 ± 0.18) mmol/L, P = 0.003,3), as compared to that in NC group. Serum factors, including LPS, tumor necrosis factor-α, and malondialdehyde levels of AS group were significantly higher than that of NC group ((1,230.00 ± 192.70) EU/L vs. (695.70 ± 213.70) EU/L), P = 0.001,1; (424.20 ± 176.90) ng/L vs. (51.20 ± 26.61) ng/L, P = 0.023,5; (3.60 ± 0.77) nmol/mL vs. (2.62 ± 0.21) nmol/mL, P = 0.025,4). Pathological evaluations revealed prominent lipid deposition area in the aortic arch, thoracic aorta, and abdominal aorta of the AS group compared with that of the NC group (4.17% ± 2.30% vs. 0, P = 0.006,7; 6.23% ± 2.95% vs. 0, P = 0.003,6; 3.78% ± 2.18% vs. 0, P = 0.008,1). TLR4, nuclear factor kappa-B p65, and tumor necrosis factor-α expression in the aorta tissue of the AS group were upregulated, whereas occludin and zonula occludens-1 expression in colon tissues was downregulated. Additionally, metabolomics identified significant differences in 21 metabolites in the feces of the AS group compared to the NC group, with further analysis linking these differences to amino acid metabolism. Conclusions::The Tibetan miniature pig model of early AS induced by high-fat intake displayed pronounced chronic inflammation. Preliminary findings suggest that the underlying mechanisms may be associated with the LPS/TLR4 pathway and intestinal metabolic disorders.

Objective::This study aimed to elucidate the effect of the lipopolysaccharides/toll-like receptor 4 (LPS/TLR4) pathway on early atherosclerosis (AS) development and its associated changes in fecal metabolites, thereby providing an experimental foundation for strategies to prevent and treat early AS.Methods::Twelve Tibetan miniature pigs aged 4-5 months were divided into normal control (NC) group and AS group (6 pigs in each). The group assignment was primarily based on body weight; Secondary criteria, including glucose, lipid profiles, and inflammatory indices, were considered to ensure balanced baseline characteristics between the 2 groups (all P > 0.05). AS group received a high-fat diet for 16 weeks to establish an AS model, while the NC group received a normal diet. Subsequently, serum levels of lipids and various inflammation and oxidative stress markers were measured. Pathological changes in the aorta and colon tissue, LPS/TLR4 pathway-associated protein expressions in the aorta, as well as occludin and zonula occludens-1 in the colon were also assessed. Proton nuclear magnetic resonance spectra technology was employed for the metabolomic analysis of fecal extracts. Results::The lipid metabolism was disrupted in AS group, with significantly higher total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels ((12.24 ± 5.24) mmol/L vs. (1.86 ± 0.27) mmol/L, P = 0.004,6; (2.39 ± 0.50) mmol/L vs. (0.83 ± 0.07) mmol/L, P = 0.000,5; (6.94 ± 2.87) mmol/L vs. (0.77 ± 0.18) mmol/L, P = 0.003,3), as compared to that in NC group. Serum factors, including LPS, tumor necrosis factor-α, and malondialdehyde levels of AS group were significantly higher than that of NC group ((1,230.00 ± 192.70) EU/L vs. (695.70 ± 213.70) EU/L), P = 0.001,1; (424.20 ± 176.90) ng/L vs. (51.20 ± 26.61) ng/L, P = 0.023,5; (3.60 ± 0.77) nmol/mL vs. (2.62 ± 0.21) nmol/mL, P = 0.025,4). Pathological evaluations revealed prominent lipid deposition area in the aortic arch, thoracic aorta, and abdominal aorta of the AS group compared with that of the NC group (4.17% ± 2.30% vs. 0, P = 0.006,7; 6.23% ± 2.95% vs. 0, P = 0.003,6; 3.78% ± 2.18% vs. 0, P = 0.008,1). TLR4, nuclear factor kappa-B p65, and tumor necrosis factor-α expression in the aorta tissue of the AS group were upregulated, whereas occludin and zonula occludens-1 expression in colon tissues was downregulated. Additionally, metabolomics identified significant differences in 21 metabolites in the feces of the AS group compared to the NC group, with further analysis linking these differences to amino acid metabolism. Conclusions::The Tibetan miniature pig model of early AS induced by high-fat intake displayed pronounced chronic inflammation. Preliminary findings suggest that the underlying mechanisms may be associated with the LPS/TLR4 pathway and intestinal metabolic disorders.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

OBJECTIVE:Prolonged sedentary behavior can acutely reduce peripheral and central vascular function,thereby increasing the risk of cardiovascular disease.Interrupting sedentary behavior may be a potential practical strategy to prevent vascular dysfunction caused by prolonged sitting.However,current research findings on its acute effects are inconsistent,and specific application recommendations have not yet been established.This study aims to perform a Meta-analysis on the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults and to explore its regulatory factors.METHODS:Following PRISMA reporting guidelines,literature search was conducted in March 2024 using the keywords of"interrupting,""sedentary,"and"vascular function"in the Web of Science Core Collection,PubMed,and China National Knowledge Infrastructure(CNKI)databases.Acute randomized crossover trials addressing the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults were included.Risk of Bias 2 developed by Cochrane was used to assess bias risk,and the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system was used to evaluate the evidence level.The"meta"and"metaphor"packages in R(version 4.2.0)were used for main effect aggregation(Hedge's g acted as the effect size indicator),publication bias testing,subgroup analysis,and regression analysis.RESULTS:Twenty-two randomized crossover trials involving 364 subjects(aged 21 to 70 years)were included.Meta-analysis results showed that compared with prolonged sitting,interrupting sedentary behavior acutely improved peripheral vascular blood flow volume(Hedge's g=0.48,95%confidence interval:0.14-0.82,P<0.01,I2=63%,low evidence level),shear stress(Hedge's g=0.65,95%confidence interval:0.37-0.93],P<0.01,I2=54%,moderate evidence level),and flow-mediated dilation(Hedge's g=0.43,95%confidence interval:0.15-0.72,P<0.01,I2=61%,moderate evidence level).Disease had a significant moderating effect on the main effect aggregation for blood flow volume(P=0.01 between subgroups),while the mode(P=0.01 between subgroups)and frequency(P=0.02 between subgroups)of interruptions had significant moderating effects on shear stress.Improvements in peripheral vascular shear stress from interrupting sedentary behavior were affected by age(β=-0.02,95%confidence interval:-0.03-0.01,P=0.09)and body mass index(β=-0.10,95%confidence interval:-0.18 to-0.02,P<0.01).Improvements in flow-mediated dilation were influenced by the total number of interruptions(β=-0.09,95%confidence interval:-0.17 to-0.01,P=0.03)and the duration of sitting during the control period(β=-0.21,95%confidence interval:-0.34 to-0.09,P<0.01).Each additional hour of sitting was associated with a 0.67%reduction in the acute improvement effect of flow-mediated dilation from interrupting sedentary behavior(P<0.01),and acute benefits disappeared when sitting control time exceeded 6 hours.A qualitative systematic review found that interrupting sedentary behavior did not significantly affect pulse wave velocity in various populations but could effectively prevent central vascular function decline in older adults due to prolonged sitting.CONCLUSION:Interrupting sedentary behavior acutely improves peripheral vascular blood flow volume(low evidence level),shear stress(moderate evidence level),and flow-mediated dilation(moderate evidence level)in adults and may prevent or protect against central vascular function decline in older adults due to prolonged sitting(very low evidence level).Characteristics of subjects(disease factors,sex,age,and body mass index),interruption intervention schemes(mode,frequency,total number of interruptions),and duration of sitting control all influence the acute improvement effects of interrupting sedentary behavior on vascular function.It is recommended that adults interrupt sedentary behavior with exercises involving large muscle groups,such as stair climbing,at high frequencies(e.g.,once every 40 minutes)with at least 5 minutes of moderate-to low-intensity activity each time,and limit the cumulative duration of prolonged sitting to no more than 6 hours per day.

Objective:To examine the risk factors and predictive value of depression following mild acute ischemic stroke in elderly individuals.The aim is to enhance early identification and intervention, ultimately leading to improved prognosis.Methods:A case-control study was conducted on 988 elderly patients with mild acute ischemic stroke.The study collected general population and social data, as well as clinical laboratory data such as blood glucose, blood lipids, and AD7C-NTP in urine.Additionally, the patients underwent assessments using the Montreal Cognitive Assessment Scale(MoCA), National Institutes of Health Stroke Scale(NHISS), Barthel index(BI), Hamilton Anxiety Scale(HAMA), and Hamilton Depression Scale(HAMD).Based on the HAMD depression scale score, the patients were divided into a nopost-stooke depression(NPSD)group and a post-stooke depression(PSD)group.The study then analyzed the related risk factors and predictive value of PSD.Results:A total of 988 patients were eligible for inclusion, with 132 being excluded and 856 being included.The NPSD and PSD groups showed significant differences in age, hypertension, smoking history, education level, and stroke history(all P<0.05).Regarding clinical data, there were statistically significant differences between the two groups in total cholesterol(TC), triacylglycerol(TG), HDL, urinary AD7C-NTP, MoCA, and HAMA scores(all P<0.05).The results of the multi-factor logistic regression analysis revealed that gender( OR=1.975, 95% CI: 1.223-3.190, P=0.005), stroke history( OR=1.352, 95% CI: 0.877-2.086, P=0.042), and HAMA score( OR=1.216, 95% CI: 0.932-1.526, P=0.043)were identified as independent risk factors for post-stroke depression in the elderly.Conversely, MoCA score( OR=0.873, 95% CI: 0.814-0.937, P<0.001)was found to be an independent protective factor.Furthermore, the ROC curve analysis demonstrated that the HAMA score(AUC=0.892, sensitivity: 0.721, specificity: 0.854, cut-off value: 9.5)exhibited significant predictive value, while the other indexes had limited predictive value. Conclusions:Gender, stroke history, and HAMA score have been identified as potential independent risk factors for post-stroke depression(PSD)in the elderly, while MoCA score may serve as an independent protective factor.Notably, HAMA score demonstrates a strong predictive ability for PSD.Early identification of these factors and timely intervention could significantly contribute to improving prognosis.

OBJECTIVE To study the toxicity-reducing effects and mechanisms of Niuhuang Jiedu Tablets(NHJDT)by gas chromatography-mass spectrometry(GC-MS)metabolomics.METHODS 24 mice were randomly divided into control,realgar(1.0 g·kg-1)and NHDJT(1.0 g·kg-1)groups with 8 mice in each group.The liver and kidney of mice were collected for patho-logic examination after 14 d oral administration to mice.The content of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in liver and creatinine(Cr)and uric acid(UA)in kidney was also determined.The differences of endogenous metabolites in liver and kidney were further analyzed by GC-MS metabolomics.RESULTS The contents of ALT and AST in the liver as well as the Cr and UA in kidney of mice were significantly changed after NHJDT intervention(P<0.05).NHJDT alleviated the pathological dam-age of liver and kidney in mice.A total of 17 biomarkers related to detoxification were screened,including citric acid,ascorbic acid,asparagine,levodopa and phenylalanine.The changes of metabolites mainly involved in glutamine and glutamate metabolism,arginine biosynthesis,tryptophan metabolism,tyrosine and tryptophan biosynthesis,and phenylalanine metabolism.CONCLUSION NHJDT with compound compatibility could reduce the hepatorenal toxicity of realgar.The detoxification mechanism may be related to the regu-lation of amino acid metabolism.