Objective:To investigate the effect of preoperative systemic inflammatory response index (SIRI) on prognosis in patients with resectable colorectal cancer.Methods:The clinical data of 355 colorectal cancer patients underwent radical resection from January 2018 to December 2022 in the Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed. The basic information, pathological data and laboratory test results were recorded, and SIRI was calculated. The patients followed up to December 2023 or death, and the overall survival (OS) and disease-free survival (DFS) were recorded. The receiver operating characteristic (ROC) curve was drawn, the optimal critical value of SIRI in patients with colorectal cancer was determined according to the maximum Yoden index, and the patients were grouped based on this. Multivariate Cox regression analysis was used to analyze the independent risk factors of prognosis in patients with colorectal cancer. Kaplan-Meier survival curve was drawn, and the log-rank test was used for comparison.Results:ROC curve analysis result showed that the optimal critical value of SIRI was 0.99, and the area under the curve was 0.556. Among the 355 patients with colorectal cancer, SIRI<0.99 was in 229 cases (low SIRI group), and SIRI≥0.99 was in 126 cases (high SIRI group). There were no statistical difference in gender composition, age, body mass index (BMI), preoperative carcinoembryonic antigen, preoperative cancer antigen 19-9 (CA19-9), tumor location, T stage, N stage, tumor stage, degree of differentiation, tumor long diameter, lymphatic invasion, vascular invasion, operating time and intraoperative blood loss between two groups ( P>0.05). The incidence of anastomotic leakage in high SIRI group was significantly higher than that in low SIRI group: 20.6% (26/126) vs. 12.2% (28/229), and there was statistical difference ( P<0.05). The median follow-up time of 355 patients was 21.7 months. The mortality and recurrence rate in high SIRI group were significantly higher than those in low SIRI group: 28.6% (36/126) vs. 19.2% (44/229) and 13.5% (17/126) vs. 6.1% (14/229), and there were statistical differences ( P<0.05). Kaplan-Meier survival curve analysis result showed that the median OS and DFS in high SIRI group were significantly lower than those in low SIRI group (17.3 months vs. 23.3 months and 15.1 months vs. 21.9 months), and there were statistical differences ( P<0.05). Multivariate Cox regression analysis result showed that the tumor stage Ⅲ to Ⅳ, preoperative CEA>5 μg/L and SIRI>0.99 were independent risk factors of OS and DFS in patients with colorectal cancer (OS: HR = 2.447, 1.951 and 1.923; 95% CI 1.461 to 4.099, 1.266 to 3.456 and 1.003 to 2.655; P<0.05. DFS: HR = 2.982, 1.782 and 1.529; 95% CI 1.663 to 4.754, 1.147 to 2.651 and 1.198 to 2.021; P<0.05). Conclusions:The preoperative SIRI is an independent risk factor of prognosis in patients with colorectal cancer. The patients with low SIRI have longer postoperative OS and DFS. The preoperative SIRI has guiding value in the prognosis assessment and treatment selection in patients with colorectal cancer.

This study investigated the regulatory potential of salidroside (SAL), a primary active compound in Rhodiola rosea L., on osteoclast differentiation by modulating the hypoxia-inducible factor 1-alpha (HIF-1a) pathway in osteoblasts. Luciferase reporter assay and chromatin immunoprecipitation (ChIP) assay were employed to validate whether the receptor activator of nuclear factor-?B ligand (RANKL) is the downstream target gene of HIF-1a in osteoblasts. The study also utilized lipopolysaccharide (LPS)-induced mouse osteolysis to examine the impact of SAL on osteolysis in vivo. Furthermore, conditioned medium (CM) from SAL-pretreated osteoblasts was used to investigate the paracrine effects on osteoclastogenesis through the HIF-1a pathway. Hypoxic condition-induced overexpression of HIF-1a upregulated RANKL levels by binding to the RANKL promoter and enhancing transcription in osteoblastic cells. In vivo, SAL significantly alleviated bone tissue hypoxia and decreased the expression of HIF-1a by downregulating the expression of RANKL, vascular endothelial growth factor (VEGF), interleukin 6 (IL-6), and angiopoietin-like 4 (ANGPTL4). In the paracrine experiment, conditioned media from SAL-pretreated osteoblasts inhibited differentiation through the HIF-1a/RANKL, VEGF, IL-6, and ANGPTL4 pathways. RANKL emerges as the downstream target gene regulated by HIF-1a in osteoblasts. SAL significantly alleviates bone tissue hypoxia and bone loss in LPS-induced osteolysis through the HIF-1a/RANKL, VEGF, IL-6, and ANGPTL4 pathways. SAL inhibits osteoclast differentiation by regulating osteoblast paracrine secretion.
Animals ; Osteoblasts/cytology* ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics* ; Glucosides/administration & dosage* ; Cell Differentiation/drug effects* ; Phenols/administration & dosage* ; Mice ; Osteoclasts/metabolism* ; RANK Ligand/genetics* ; Rhodiola/chemistry* ; Osteogenesis/drug effects* ; Signal Transduction/drug effects* ; Interleukin-6/genetics* ; Male ; RAW 264.7 Cells ; Osteolysis/genetics* ; Humans ; Mice, Inbred C57BL

Objective:To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and 24-h urinary calcium excretion (24-h UCaE) and hypercalciuria in Chinese adults.Methods:This cross-sectional study was conducted from March 2022 to March 2023 in nine cities in China and included 1 239 residents. Demographic characteristics were collected through questionnaires and physical examinations, fasting blood samples were assessed for bone metabolism indicators, and 24-h urine samples were used to determine the 24-h UCaE. Multiple linear regression analysis was used to explore the relationship between serum 25(OH)D and 24-h UCaE and bone metabolism indexes. The relationship between serum 25(OH)D and hypercalciuria was analyzed using a multiple logistic regression model combined with restricted cubic spline modeling.Results:The mean participant age was (47.9±18.1) years, of which 453 (36.6%) were male. The percentages of vitamin D sufficiency, insufficiency, and deficiency were 7.6% (94/1 239), 29.0% (359/1 239), and 63.4% (786/1 239), respectively. The multiple linear regression model showed that after adjusting for the covariates the 24-h UCaE gradually increased with higher levels of 25(OH)D ( P overall <0.001, P nonlinear <0.001). The logistic regression analysis revealed that compared with the vitamin D deficient group, the OR for the prevalence of hypercalciuria in the vitamin D sufficient and vitamin D insufficient groups were 3.290 (95% CI 1.745 to 6.202) and 3.742 (95% CI 2.458 to 5.697), respectively. The results of the restricted cubic spline modeling showed a positive nonlinear relationship between 25(OH)D and the prevalence of hypercalciuria ( P overall <0.001, P nonlinear <0.001). The prevalence of hypercalciuria increased when 25(OH)D was >17.00 μg/L and peaked at 26.71 μg/L, after which there was a decreasing trend in the prevalence of hypercalciuria with increasing 25(OH)D. Conclusion:Associations between serum 25(OH)D levels and urinary calcium excretion and the prevalence of hypercalciuria were observed in the Chinese adult population.

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 investigate the effect of preoperative systemic inflammatory response index (SIRI) on prognosis in patients with resectable colorectal cancer.Methods:The clinical data of 355 colorectal cancer patients underwent radical resection from January 2018 to December 2022 in the Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed. The basic information, pathological data and laboratory test results were recorded, and SIRI was calculated. The patients followed up to December 2023 or death, and the overall survival (OS) and disease-free survival (DFS) were recorded. The receiver operating characteristic (ROC) curve was drawn, the optimal critical value of SIRI in patients with colorectal cancer was determined according to the maximum Yoden index, and the patients were grouped based on this. Multivariate Cox regression analysis was used to analyze the independent risk factors of prognosis in patients with colorectal cancer. Kaplan-Meier survival curve was drawn, and the log-rank test was used for comparison.Results:ROC curve analysis result showed that the optimal critical value of SIRI was 0.99, and the area under the curve was 0.556. Among the 355 patients with colorectal cancer, SIRI<0.99 was in 229 cases (low SIRI group), and SIRI≥0.99 was in 126 cases (high SIRI group). There were no statistical difference in gender composition, age, body mass index (BMI), preoperative carcinoembryonic antigen, preoperative cancer antigen 19-9 (CA19-9), tumor location, T stage, N stage, tumor stage, degree of differentiation, tumor long diameter, lymphatic invasion, vascular invasion, operating time and intraoperative blood loss between two groups ( P>0.05). The incidence of anastomotic leakage in high SIRI group was significantly higher than that in low SIRI group: 20.6% (26/126) vs. 12.2% (28/229), and there was statistical difference ( P<0.05). The median follow-up time of 355 patients was 21.7 months. The mortality and recurrence rate in high SIRI group were significantly higher than those in low SIRI group: 28.6% (36/126) vs. 19.2% (44/229) and 13.5% (17/126) vs. 6.1% (14/229), and there were statistical differences ( P<0.05). Kaplan-Meier survival curve analysis result showed that the median OS and DFS in high SIRI group were significantly lower than those in low SIRI group (17.3 months vs. 23.3 months and 15.1 months vs. 21.9 months), and there were statistical differences ( P<0.05). Multivariate Cox regression analysis result showed that the tumor stage Ⅲ to Ⅳ, preoperative CEA>5 μg/L and SIRI>0.99 were independent risk factors of OS and DFS in patients with colorectal cancer (OS: HR = 2.447, 1.951 and 1.923; 95% CI 1.461 to 4.099, 1.266 to 3.456 and 1.003 to 2.655; P<0.05. DFS: HR = 2.982, 1.782 and 1.529; 95% CI 1.663 to 4.754, 1.147 to 2.651 and 1.198 to 2.021; P<0.05). Conclusions:The preoperative SIRI is an independent risk factor of prognosis in patients with colorectal cancer. The patients with low SIRI have longer postoperative OS and DFS. The preoperative SIRI has guiding value in the prognosis assessment and treatment selection in patients with colorectal cancer.

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 investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and 24-h urinary calcium excretion (24-h UCaE) and hypercalciuria in Chinese adults.Methods:This cross-sectional study was conducted from March 2022 to March 2023 in nine cities in China and included 1 239 residents. Demographic characteristics were collected through questionnaires and physical examinations, fasting blood samples were assessed for bone metabolism indicators, and 24-h urine samples were used to determine the 24-h UCaE. Multiple linear regression analysis was used to explore the relationship between serum 25(OH)D and 24-h UCaE and bone metabolism indexes. The relationship between serum 25(OH)D and hypercalciuria was analyzed using a multiple logistic regression model combined with restricted cubic spline modeling.Results:The mean participant age was (47.9±18.1) years, of which 453 (36.6%) were male. The percentages of vitamin D sufficiency, insufficiency, and deficiency were 7.6% (94/1 239), 29.0% (359/1 239), and 63.4% (786/1 239), respectively. The multiple linear regression model showed that after adjusting for the covariates the 24-h UCaE gradually increased with higher levels of 25(OH)D ( P overall <0.001, P nonlinear <0.001). The logistic regression analysis revealed that compared with the vitamin D deficient group, the OR for the prevalence of hypercalciuria in the vitamin D sufficient and vitamin D insufficient groups were 3.290 (95% CI 1.745 to 6.202) and 3.742 (95% CI 2.458 to 5.697), respectively. The results of the restricted cubic spline modeling showed a positive nonlinear relationship between 25(OH)D and the prevalence of hypercalciuria ( P overall <0.001, P nonlinear <0.001). The prevalence of hypercalciuria increased when 25(OH)D was >17.00 μg/L and peaked at 26.71 μg/L, after which there was a decreasing trend in the prevalence of hypercalciuria with increasing 25(OH)D. Conclusion:Associations between serum 25(OH)D levels and urinary calcium excretion and the prevalence of hypercalciuria were observed in the Chinese adult population.

Objective:To investigate the status of medical care seeking delay and diagnosis delay of pulmonary tuberculosis (PTB) patients in Tongzhou District and Changping District of Beijing, analyze the related factors and put forward suggestions for early detection and scientific management of PTB patients.Methods:A retrospective epidemiological survey was conducted to collect the incidence data of PTB registered in Tongzhou and Changping from January 1 to December 31, 2021 by using the Chinese Tuberculosis Information Management System, and telephone interview were used for information supplement. Multivariate logistic regression model and decision tree model were used to analyze the influencing factors of medical care seeking delay and diagnosis delay of PTB patients.Results:In 2021, the medical care seeking delay time M( Q1, Q3) in the PTB patients in Tongzhou and Changping was 11 (5, 26) days, with a delay rate of 41.71%. Results from multivariate logistic regression model analysis revealed that factors influencing the medical care seeking delay included regular health check-up ( OR=0.033, 95% CI: 0.008-0.147), coughing for less than 2 weeks or showing any symptom of PTB before medical care seeking ( OR=0.378, 95% CI: 0.215-0.665), showing other symptoms before medical care seeking( OR=2.791, 95% CI: 1.710-4.555), no work or school in medical care seeking ( OR=2.990, 95% CI: 1.419-6.298). The diagnosis delay time M( Q1, Q3) in the PTB patients was 8 (0, 18) days, with a delay rate of 35.20%. Multivariate logistic regression model analysis revealed that the factors influencing the diagnosis delay of PTB included being diagnosed at a specialized tuberculosis hospital ( OR=0.426, 95% CI: 0.236-0.767) or a tuberculosis prevention and control institution ( OR=1.843, 95% CI: 1.061-3.202) and being traced as a source of infection ( OR=2.632, 95% CI: 1.062-6.521). The overall performance of the multivariate logistic regression model was comparable to that of the decision tree model, with the decision tree model exhibiting higher sensitivity but lower specificity. Conclusions:The medical care seeking delay rate and diagnosis delay rate of tuberculosis in Tongzhou and Changping were at low levels in 2021. However, it is still necessary to strengthen the health education and active screening, improve the public awareness of PTB prevention and control, and further improve the level of medical services and medical access to reduce the medical care seeking delay and diagnosis delay of PTB patients.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.