Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To summarize the characteristics of autosomal recessive axonal neuropathy with neuromyotonia (ARAN-NM) caused by HINT1 gene mutation. Methods:Retrospective case summary.Clinical data of 2 Tibetan siblings diagnosed with ARAN-NM in the Department of Pediatrics of Peking University First Hospital in August 2023 were retrospectively analyzed.A review of literature reporting relevant Chinese patients was conducted.Results:The proband and her elder brother were aged 13 and 19, respectively.Both developed abnormal gait at the age of 11, followed by varus, claudication, and weak thumb strength.The proband also had neuromyotonia.Physical examinations showed that the proband and her elder brother had decreased muscle strength of the extremities, mainly in the thumbs and distal ends of lower limbs.The distal muscles of the proband′s lower extremities and the muscles of both hands of the proband′s elder brother were atrophied.Both feet showed talipes equinovarus in the proband and her elder brother.The proband′s electromyography (EMG) showed peripheral nerve injuries (motor and sensory axonal involvement, especially in distal ends) and myotonic potentials.The trio-whole exon sequencing detected homozygous pathogenic variation in HINT1 gene in both the proband and her elder brother, who were diagnosed as ARAN-NM based on c. 169A>G (p.K57E). After the Carbamazepine treatment, the proband′s neuromyotonia, numbness and weakness were relieved.Both the proband and her elder brother underwent orthopaedic surgery and rehabilitation.Their foot deformities and gait were significantly improved.Two Chinese literatures (2 patients) and four English literatures (8 patients) were retrieved.Including the proband and her elder brother in this study, there were 12 ARAN-NM patients, 10 of whom had clinical data.The ages of onset and diagnosis were 2-16 (1 case unknown) and 13-33 years old, respectively.Myasthenia was present in 9 patients, especially in distal ends.Eight patients were complicated with neuromyotonia, nine patients with muscle atrophy, seven patients with foot deformity, and two patients with sensory disturbance.Creatine kinase(CK) was elevated in all 9 patients tested or CK.EMG showed neurogenic injuries in all patients and neuromyotonia discharge in six patients.Three patients were treated with Carbamazepine, and some symptoms were relieved.Missense/nonsense mutations were found in the 12 patients, and the high-frequency variation was c. 112T>C (p.C38R). Conclusions:ARAN-NM is a rare autosomal recessive neuromuscular disease caused by HINT1 gene mutation.There is no ethnic difference in clinical manifestations, mainly distal limb weakness with neuromyotonia.Carbamazepine can alleviate some symptoms, and orthopaedic surgery can improve foot deformity and gait.

Objective:To investigate application evaluation of acceptance and commitment therapy among patients undergoing early stage of peritoneal dialysis.Methods:A total of 100 patients who undergoing early stage of peritoneal dialysis from March 2018 to January 2020 in Nephrology of Shanghai Tongji Hospital were assigned to the experimental groupand control group according to the random number table method with 50 cases in each group. The control group received routine nursing care, while the experimental group implemented 6-week acceptance and commitment therapy. The effect was assessed by Self-report Psychosocial Adjustment to Illness Scale (PAIS-SR) and Self-perceived Burden Scale (SPBS).Results:After intervention, the scores of health care, working ability, family relationship, communication, entertainment and psychological status dimensionand total PAIS-SR were (7.93 ± 1.50), (9.11 ± 1.38), (6.61 ± 1.73), (6.82 ± 1.42), (6.82 ± 1.66), (8.18 ± 1.79), (50.91 ± 4.24) points in the experimental group, which were lower than those in the control group (9.63 ± 1.22), (10.78 ± 1.64), (7.50 ± 2.07), (7.57 ± 2.05), (7.50 ± 1.07), (9.43 ± 1.92), (58.02 ± 4.13) points, the differences were statistically significant between the two groups( t values were 2.02-8.07, all P<0.05). After intervention, the scores of physical burden, emotional burden dimension and total SPBS were (9.68 ± 1.75), (14.54 ± 1.76), (30.89 ± 2.99) points in the experimental group, which were lower than those in the control group (10.80 ± 1.82), (16.11 ± 2.04), (33.65 ± 3.19) points, the differences were statistically significant ( t=2.98, 3.89, 4.24, all P<0.05). Conclusions:Acceptance and commitment therapy can improve the ability of disease adaptability and decrease self-perceived burden in patients undergoing early stage of peritoneal dialysis.

Objective To make a conclusion about the methods and main points of surgical position for cervical artificial disc replacement (CADR). Methods We collected the data from January to December 2015 in West China Hospital of Sichuan University. It included 102 patients in the surgical group of cervical spine, which were cervical vertebra degeneration and doing CADR according to the segment, quantity of the replacement and whether belonged to hybrid surgical method, then we analyzed and determined how to achieve the desired surgical position. Results The surgical positions of the patients in this group all conformed to the requirements of the replacement and gave intraoperative excellent exposure and less blood loss, made the vision of decompression clear and thorough, made the position of replacement prosthesis great. There were no postoperative complications. The patients all healed and were discharged in 5 to 7 days after operation. There was no position offset of prosthesis and no extrusion in the following 6 to 18 months. It restored the ideal physiological lordosis of the cervical spine. Conclusions According to the different segment of the replacement, we analyze and remain the location of the preoperative cervical spinal neutrality and a bit of extension which make the artificial cervical disc in favor of being well placed during an operation and promote cervical spine to maintain normal physiological lordosis during early post-operation, and greatly reduce the incidence of postoperative pain of neck and shoulder.

Objective To construct the functions for sex discrimination with Chinese humerus. Methods 12 variables of both left and right were selected from 103 individuals with known sex from 9 different provinces. The data were then obtained. The test was performed between males and females by using SPSS soft ware. After eliminate those variables which sex difference was not obvious. Sex discriminating functions were established by using Fisher mothod. Results There were 20 discriminating functions by the measuring single Chinese humerus, Sex correct rate was 75.9% ~89.3%. They were 2 discriminating functions of the proximal humerus epiphysis. The sex correct rate was 83.6% -85.7%. They were 2 discriminating functions of the middle humerus diaphysis. The sex correct rate was 81.3 % -83.9 %. They were 2 discriminating functions of the distal humerus epiphysis. The sex correct rate was 82%. The sex correct rate of the whole left humerus was 87% and of the whole right humerus was 90.9%. The sex correst rate of both left and right humerus was 96.3 % . Conclusion The sex discriminating functions were new method for forensic science practice in China.