Objective:To formulate refined management strategies to improve the operation quality and protective effect of medical X-ray diagnosis equipment based on the risk analysis of the correlation of medical X-ray diagnostic equipment.Methods:The used 41 medical X-ray diagnosis equipment in Fuwai Hospital,Chinese Academy of Medical Sciences from January 2022 to December 2023 were selected.According to different management modes for equipment,they were managed respectively by the conventional management mode(20 units)and the management mode with risk analysis of the correlation(21 units).The risk grades of correlation of management mode with risk analysis of the correlation were classified on the basis of the probability of risk and the degree of harm in medical X-ray diagnosis equipment.The protection management of equipment was conducted from three aspects included the location of equipment,the staffs and subjects.A self-made questionnaire was used to investigate the satisfactions of engineers of using management for equipment,operators,and staffs of operating and maintaining equipment for the two kinds of management modes.The protection quality,failure rate of equipment,and qualification rate of protection of medical X-ray diagnosis equipment under different management modes were compared.Results:The quality scores of operation safety,regular inspection,maintenance and repair,and shielding protection for radiation of medical X-ray diagnosis equipment that adopted the management mode with risk analysis of the correlation were respectively(92.14±3.36),(91.47±2.41),(92.54±3.32)and(91.69±3.57)points,all of which were higher than those of the conventional management mode,and the differences of them were statistically significant(t=16.396,17.368,19.688,14.401,P<0.05).The failure rate of the 21 medical X-ray diagnosis equipment that adopted the management mode with risk analysis of correlation was 0,which was lower than 20.00%of the conventional management mode.The qualified rate of protection was 95.23%,which was higher than 70.00%of the conventional management mode,and the differences of them were statistically significant(x2=4.654,4.608,P<0.05).The satisfaction scores of engineers of using equipment,operators and staffs of operating and maintaining equipment for the protective effect of adopting the management mode with risk analysis of correlation were respectively(94.69±4.02),(93.21±4.36)and(92.54±3.47)points,all of which were higher than those of the conventional management mode,and the differences were statistically significant(t=16.902,11.291,12.020,P<0.05).Conclusion:The process-based protection management strategy on the basis of risk analysis of correlation for medical X-ray diagnosis equipment can prevent risks of medical X-ray diagnostic equipment,and improve the operation quality of the equipment,and reduce the operation risks of the equipment,and maximize the enhancement for management quality of medical X-ray diagnosis equipment.

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.

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.

This article summarizes the current status and research advances in the diagnosis and treatment of pediatric skin tumors and vascular malformations, with particular emphasis on the pathogenesis, clinical manifestations, diagnostic approaches, and therapeutic options for hemangiomas, vascular malformations, histiocytosis, mastocytosis, and mycosis fungoides. With the enhanced understanding of distinctive growth and regression patterns of pediatric skin tumors, therapeutic strategies have been progressively optimized. However, significant challenges persist in managing pediatric skin neoplasms. Future investigations should prioritize the establishment of pediatric-specific molecular diagnostic and therapeutic systems, and integrate precision medicine with individualized strategies, so as to improve clinical outcomes and quality of life in affected children.

Objective:To investigate clinical characteristics, treatment approaches, and prognosis of drug-induced hypersensitivity syndrome (DIHS) in children.Methods:A retrospective analysis was performed on clinical data from pediatric inpatients with DIHS in Department of Dermatology, Beijing Children's Hospital from 2009 to 2023. The clinical data included demographic characteristics, clinical manifestations, laboratory findings, treatment regimens, and outcomes.Results:A total of 103 children with DIHS were included, comprising 54 males (52.4%) and 49 females (47.6%), with ages ( M [ Q1, Q3]) of 2.3 (1.2, 4.5) years. Primary causative drugs were antibiotics (52 cases, 45.2%), antiepileptic drugs (41 cases, 35.7%), and nonsteroidal anti-inflammatory drugs (19 cases, 16.5%), with a median latency period of 12 days. All patients presented with rashes, including 72 (69.9%) with maculopapular rashes, 69 (67.0%) with edema (including 46 with facial edema). Lip involvement occurred in 25 cases (24.3%), and mucosal involvement was noted in 11 cases (10.7%). Additionally, 102 (99.0%) patients had fever, and 79 (76.7%) presented with lymphadenectasis. Eosinophilia was present in 64 cases (62.1%). Among 84 patients tested for atypical lymphocytes, 51 (60.7%) showed elevated percentages of atypical lymphocytes. Liver involvement was noted in 94 cases (91.3%), followed by pulmonary involvement in 31 (30.1%), gastrointestinal symptoms in 25 (24.3%), cardiac involvement in 14 (13.6%), renal involvement in 10 (9.7%), and pancreatic involvement in 7 cases (6.8%). Among 82 patients tested for blood immunocytes, 49 (59.8%) showed decreased percentages of B lymphocytes, and 69 (84.1%) showed decreased percentages of natural killer cells. Of 88 patients tested for serum immunoglobulins, 40 (45.5%) showed decreased IgA levels. Among 20 patients tested for serum cytokines, 15 (75.0%), 15 (75.0%), 13 (65.0%), and 12 (60.0%) showed elevated levels of interleukin (IL) -5, IL-6, IL-10, and interferon-γ, respectively. All patients received systemic glucocorticoid therapy, among whom 86 additionally received intravenous immunoglobulin therapy, 4 received Janus kinase inhibitors, and 3 received dupilumab. Five patients died, 9 developed hemophagocytic lymphohistiocytosis, 6 developed bronchiolitis obliterans, and 5 experienced long-term immune-related sequelae. Conclusions:Among these children with DIHS, antibiotics were the most common causative drugs, and the latency period could be shorter than 2 weeks. In addition to the common involvement of the liver and lungs, gastrointestinal and cardiac impairments were relatively frequent, while renal involvement was rare. Immunological features included decreased percentages of B lymphocytes and natural killer cells, reduced IgA levels, and elevated levels of cytokines such as IL-5, IL-6, IL-10, and interferon-γ.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To analyze the relationship between obesity indicators,muscle mass indices and hypertension in Dongxiang adults,and establish and evaluate a Nomogram model based on these indicators used to predict the risk of hypertension in this population.Methods A total of 1209 Dongxiang adults from Linxia Prefecture,Gansu Province were selected,11 obesity indicators and 5 muscle mass indicators,including neck circumference(NC),waist-to-hip ratio(WHR),BMI,ponderal index(PI),conicity index(CI),a body shape index(ABSI),body roundness index(BRI),abdominal volume index(AVI),hip index(HI),body adiposity index(BAI),and the ratio of limb fat mass to body weight(LFWR),appendicular skeletal muscle mass(ASM),appendicular skeletal muscle mass index(ASMI),appendicular skeletal muscle mass to BMI ratio(ASMBMI),skeletal muscle index(SMI),and trunk muscle mass to body weight ratio(TMWR)were measured.Logistic regression analysis was used to explore the relationship between each indicator and hypertension.Nomogram prediction model was constructed and validated by using R language.Results Among Dongxiang males,the NC,BMI,PI,WHR,CI,AVI,BRI,BAI,ASM,ASMI,and LFWR were lower in the normal and high-normal blood pressure groups compared to the hypertensive group,while SMI,ASMBMI,and TMWR were higher.Among females,similar trends were observed,with lower NC,BMI,PI,WHR,CI,AVI,BRI,BAI,and LFWR in the normal blood pressure and high-normal blood pressure groups compared to the hypertensive group,but SMI,ASMBMI,and TMWR higher than the hypertensive group(P＜0.05).Results of multivariate Logistic regression analysis indicated that age,NC,and WHR were risk factors for hypertension in Dongxiang adults,while was protective factor(P＜0.05).The area under curve(AUC)of the Nomogram model constructed based on these factors was 0.796,and the Bootstrap internal validation C-index was 0.7957,indicating good calibration of the model.Conclusion The Nomogram model constructed based on obesity and muscle mass indicators has good predictive efficiency for predicting the risk of hypertension in Dongxiang adults.