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.

Hepatocellular carcinoma (HCC) is a malignant tumor that endangers human health globally. Diagnosis and treatment at an early stage are the keys to receiving radical treatment and improving survival rates. A clinical solution for HCC diagnosis at an early stage is the combination of serum markers and imaging technology. A basic strategy for screening and diagnosis at an early stage with a favorable cost-effectiveness ratio is the alpha-fetoprotein combined with abdominal ultrasound. The HCC diagnostic rate at an early stage can be improved with AFP combined with des-gamma carboxy prothrombin, aldehyde-keto reductase 1B10, liquid biopsy, and imaging tests. The radical treatment for early-stage HCC has entered a new era of diversification. The effectiveness of radical treatment can assist in improving the combined use of small molecule targeted medications and immune checkpoint inhibitors. The prevention and control of liver cancer will move toward a new stage of greater precision and efficiency with the advancement of biotechnology and policy promotion.

Objective:To establish and explore a novel model and its clinical application value based on abnormal des-gamma-carboxy prothrombin (DCP) for the early-stage diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).Methods:A total of 420 cases with chronic HBV infection with nodular liver lesions examined by imaging at the Third Hospital of Hebei Medical University from January 2021 to June 2024 were retrospectively selected. They were divided into the HBV-HCC group (182 cases) and the control group (238 cases) according to the current HCC diagnostic criteria. The basic information of patients, liver-related biochemical indicators, serum DCP, alpha-fetoprotein (AFP) levels, and the efficacy of combined detection in diagnosing early-stage HCC were collected and analyzed. A DSGAA model based on DCP (D) combined with gender (S), γ-glutamyl transferase (GGT, G), AFP (A) and age (A) as independent variables was constructed. The diagnostic performance of the novel model was compared with that of the traditional model through nomogram visualization output and calibration curve.Results:The age, sex, hemoglobin, albumin, alanine aminotransferase, alkaline phosphatase, and GGT levels were significantly higher in patients with HCC than those of the control group ( P<0.05). The positivity detection rate in patients with HBV-HCC was significantly higher in DCP than that of AFP (85.71% vs. 59.89%, P<0.05). The abnormal detection rate of DCP in patients with AFP-negative was 76.7%. The sensitivity for diagnosing HCC was significantly higher in DCP than AFP (73.63% vs. 64.29%, P<0.05), with specificity of 83.6% in all. The specificity for diagnosing early-stage HCC was 89.09%, surpassing that of AFP at 68.06% ( P<0.05). The area under the receiver operating characteristic curve (AUC) for the constructed DSGAA diagnostic model was 0.8841, with an optimal cutoff value of 0.377, a sensitivity of 80.22%, and a specificity of 86.13%. The AUC for diagnosing early-stage HCC was 0.8122, with a sensitivity of 66.18%, and a specificity of 86.13%, and the diagnostic efficacy was higher than other models ( P<0.05). Conclusion:DCP has superior diagnostic efficacy for HBV-related HCC, and the DSGAA model is expected to be used as a new method for screening and diagnosing early-stage HBV-related HCC.

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.

Hepatocellular carcinoma (HCC) is a malignant tumor that endangers human health globally. Diagnosis and treatment at an early stage are the keys to receiving radical treatment and improving survival rates. A clinical solution for HCC diagnosis at an early stage is the combination of serum markers and imaging technology. A basic strategy for screening and diagnosis at an early stage with a favorable cost-effectiveness ratio is the alpha-fetoprotein combined with abdominal ultrasound. The HCC diagnostic rate at an early stage can be improved with AFP combined with des-gamma carboxy prothrombin, aldehyde-keto reductase 1B10, liquid biopsy, and imaging tests. The radical treatment for early-stage HCC has entered a new era of diversification. The effectiveness of radical treatment can assist in improving the combined use of small molecule targeted medications and immune checkpoint inhibitors. The prevention and control of liver cancer will move toward a new stage of greater precision and efficiency with the advancement of biotechnology and policy promotion.

Objective:To establish and explore a novel model and its clinical application value based on abnormal des-gamma-carboxy prothrombin (DCP) for the early-stage diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).Methods:A total of 420 cases with chronic HBV infection with nodular liver lesions examined by imaging at the Third Hospital of Hebei Medical University from January 2021 to June 2024 were retrospectively selected. They were divided into the HBV-HCC group (182 cases) and the control group (238 cases) according to the current HCC diagnostic criteria. The basic information of patients, liver-related biochemical indicators, serum DCP, alpha-fetoprotein (AFP) levels, and the efficacy of combined detection in diagnosing early-stage HCC were collected and analyzed. A DSGAA model based on DCP (D) combined with gender (S), γ-glutamyl transferase (GGT, G), AFP (A) and age (A) as independent variables was constructed. The diagnostic performance of the novel model was compared with that of the traditional model through nomogram visualization output and calibration curve.Results:The age, sex, hemoglobin, albumin, alanine aminotransferase, alkaline phosphatase, and GGT levels were significantly higher in patients with HCC than those of the control group ( P<0.05). The positivity detection rate in patients with HBV-HCC was significantly higher in DCP than that of AFP (85.71% vs. 59.89%, P<0.05). The abnormal detection rate of DCP in patients with AFP-negative was 76.7%. The sensitivity for diagnosing HCC was significantly higher in DCP than AFP (73.63% vs. 64.29%, P<0.05), with specificity of 83.6% in all. The specificity for diagnosing early-stage HCC was 89.09%, surpassing that of AFP at 68.06% ( P<0.05). The area under the receiver operating characteristic curve (AUC) for the constructed DSGAA diagnostic model was 0.8841, with an optimal cutoff value of 0.377, a sensitivity of 80.22%, and a specificity of 86.13%. The AUC for diagnosing early-stage HCC was 0.8122, with a sensitivity of 66.18%, and a specificity of 86.13%, and the diagnostic efficacy was higher than other models ( P<0.05). Conclusion:DCP has superior diagnostic efficacy for HBV-related HCC, and the DSGAA model is expected to be used as a new method for screening and diagnosing early-stage HBV-related HCC.

Objective:To investigate the effect of integrated psychological and behavioral intervention on cognitive function and P300 in children with attention-deficit/hyperactivity disorder (ADHD).Methods:A randomized controlled study was conducted on 112 children with ADHD admitted to the Shaoxing 7 th People's Hospital from March 2022 to September 2023. These children were randomly divided into two groups: Group A ( n = 56) and Group B ( n = 56), using a random number table method. Group A received conventional drug treatment, whereas Group B received conventional drug treatment and an integrated psychological and behavioral intervention. The treatment lasted for 3 months. Before and after treatment, the levels of norepinephrine (NE) and dopamine (DA), scores on the Integrated Visual and Auditory Continuous Performance Test, electroencephalogram θ/β ratio, and P300 (latency and amplitude) were determined in each group. The clinical efficacy of the treatment was evaluated in both groups. Results:After treatment, the NE and DA levels in Group B were (340.83 ± 43.22) ng/L and (1.12 ± 0.25) ng/L, respectively. These levels were significantly lower than those in Group A [(416.15 ± 48.37) ng/L, (1.30 ± 0.31) ng/L, t = 8.69, 3.38, both P < 0.05]. The full scale attention quotient and full scale response control quotient in Group B were (82.52 ± 14.15) points and (96.34 ± 13.95) points, respectively. These values were significantly higher than those in Group A [(75.20 ± 13.83) points, (90.62 ± 15.16) points, t = -2.77, -2.08, both P < 0.05). The electroencephalogram θ/β ratio was significantly lower in Group B than in Group A ( t = 3.22, P < 0.05). The latencies of P300 in the Cz and Fz regions in Group B were (346.21 ± 40.52) ms and (344.65 ± 39.52) ms, respectively. The latencies were significantly shorter than those in Group A [(376.16 ± 43.04) ms, (369.35 ± 42.16) ms, t = 3.79, 3.20, both P < 0.05]. Similarly, the amplitudes of P300 in the Cz and Fz regions were significantly greater in Group B [(7.73 ± 1.80) μV, (7.22 ± 1.73) μV] than in Group A [(5.90 ± 1.15) μV and (5.76 ± 1.12) μV] ( t = -6.41, -5.30, both P < 0.05). The total response rate in Group B was significantly higher than that in Group A [94.6% (53/56) vs. 82.1% (46/56), χ2 = 4.26, P < 0.05]. Conclusion:The integrated psychological and behavioral intervention in children with ADHD is good. It can reduce NE and DA levels, improve cognitive function, decrease electroencephalogram θ/β , and improve P300.

Objective:To analyze the clinical application value of serum heme oxygenase (HO)-1expression level in non-alcoholic fatty liver disease (NAFLD) and, based on that, establish a diagnostic model combined with glucose regulatory protein 78 (GRP78) so as to clarify its diagnostic effectiveness and application value.Methods:A total of 210 NAFLD patients diagnosed by abdominal B-ultrasound and liver elastography were included, and at the same time, 170 healthy controls were enrolled. The general clinical data, peripheral blood cell counts, and biochemical indicators of the research subjects were collected. The expression levels of HO-1 and GRP78 were detected using an enzyme-linked immunosorbent assay. Multivariate analysis was used to screen independent risk factors for NAFLD. Visual output was performed through nomogram diagrams, and the diagnostic model was constructed. Receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA) were used to evaluate the diagnostic effectiveness of NAFLD. Measurement data were analyzed using a t-test or Mann-Whitney U rank sum test to detect data differences between groups. Enumeration data were analyzed using the Fisher's exact probability test or the Pearson χ2 test. Results:Compared with the healthy control group, the white blood cell count, aspartate aminotransferase (AST), alanine aminotransferase, gamma-glutamyl transferase (GTT), fasting blood glucose (Glu), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), serum HO-1, and GRP78 levels were significantly increased in the NAFLD group patients ( P ?

Objective To investigate the health education needs and available resources in schistosomiasis-endemic areas based on integration of community resources, and to explore the operation pathways for health education and promotion during the stage of schistosomiasis elimination. Methods A community was selected from Nanji Township, Xinjian District, Nanchang City, Jiangxi Province around the Poyang Lake areas as the study site, and a questionnaire survey on health education needs for schistosomiasis control was conducted among permanent residents at ages of 20 years in the community during the period between June and July, 2022 using face-to-face interviews. In addition, the resources available for the community-based schistosomiasis control health education were investigated among workers in township-level specialized institutions, members of civil society organizations, villagers, teachers and high and primary school students through field observations, field surveys and thematic interviews. Results A total of 304 individuals participated in the questionnaire survey on community-based health education needs for schistosomiasis control, and 94.41% (287/304) and 93.42% (284/304) of the respondents were most interested in knowing/understanding knowledge of the morphology of schistosomes and knowledge associated with the transmission route of schistosomiasis. The four most popular patterns for disseminating schistosomiasis control knowledge included live broadcasting of schistosomiasis control videos (94.41%, 287/304), printed brochures (89.80%, 273/304), special lectures by doctors (62.50%, 190/304) and physical health education materials for schistosomiasis control (61.51%, 187/304). There were 96.71% (294/304) and 77.63% (236/304) of respondents that accepted the participation of township healthcare center and township government/village committees in dissemination of schistosomiasis control knowledge, and there were 95.72% (291/304) and 80.59% (245/304) of respondents that mainly acquired schistosomiasis control knowledge through village allocation of leaflets and volunteer schistosomiasis control activities, respectively. There was 96.71% (294/304) of respondents participating in the dissemination activities of schistosomiasis control knowledge held by village committees, township healthcare centers, and high and primary schools/kinder-gartens, and 61.25% (177/289) of respondents were willing to participate in volunteer schistosomiasis control activities. A total of 115 individuals participated in the survey of available resources for community-based schistosomiasis control health education, and there were a large number of organizational, human and cultural resources in the community that were useful for health communication services. Conclusions The abundant human and material resources from rural communities in schistosomiasis-endemic areas may be integrated into schistosomiasis control health education to generate a rural health education pathway with the joint participation of schistosomiasis control institutions, township governments, community departments and community residents, which may provide insights into the future development of schistosomiasis control health education.

Treatment with molecular targeted drugs and immune checkpoint inhibitors (ICIs) has become the first-line treatment options for unresectable HCC (hepatocellular carcinoma) and is also one of the anti-recurrence therapies of choice for patients at high risk of recurrence following radical treatment. First-line molecular targeted drugs combined with ICIs or dual-immune therapy significantly increase the median overall survival and objective response rate compared to single-targeted drugs. Targeted therapy and immunotherapy are suitable for HCC patients with Child-Pugh classes A~B. Liver damage caused by targeted drugs includes abnormal transaminases and bilirubin and, in severe cases, hypoproteinemia, ascites, and other occurrences. ICIs-associated immune-mediated hepatitis (IMH) mostly occurs within one to three sessions of treatment (4~12 weeks) and can be treated with glucocorticoids. However, immunosuppressants such as mycophenolate mofetil may be used as necessary.Targeted drugs and ICIs with different mechanisms of action can be selected based on the systemic condition and tumor treatment needs following the restoration of normal liver function.