Objective:To investigate the current status of postoperative Day 1 ambulation in patients undergoing posterior lumbar interbody fusion (PLIF) surgery under an enhanced recovery after surgery (ERAS) protocol, analyze the influencing factors of successful ambulation on postoperative Day 1, and explore the impact of early ambulation on postoperative recovery.Methods:Data from 397 patients who underwent PLIF surgery at Beijing Jishuitan Hospital, Capital Medical University, from September 2023 to July 2024 were retrospectively collected. Patients were divided into two groups based on whether they successfully ambulated on postoperative Day 1: the successful ambulation on Day 1 group and the delayed ambulation group. Binary Logistic regression was used to analyze the factors influencing successful ambulation on postoperative Day 1. Postoperative recovery indicators, including catheter removal time, hospital length of stay, drainage volume on postoperative Day 3, and pain scores for the low back and legs, were compared between the two groups.Results:A total of 378 patients were included in the analysis. Among them, 316 patients (83.6%) successfully ambulated on postoperative Day 1, while 62 patients (16.4%) had delayed ambulation. Logistic regression analysis indicated that postoperative Day 1 hemoglobin classification and pre-ambulation low back pain score in the supine position were independent factors influencing successful ambulation on Day 1 ( P<0.05). The successful ambulation group had a shorter catheter removal time and hospital stay compared to the delayed ambulation group, with statistically significant differences ( P<0.05). There were no significant differences between the two groups in postoperative drainage volume, low back pain scores, leg pain scores, or Oswestry Disability Index scores before discharge (all P>0.05) . Conclusions:Postoperative Day 1 hemoglobin levels and pre-ambulation low back pain scores are independent factors influencing the success of ambulation on postoperative Day 1 in patients undergoing PLIF surgery. Early ambulation on postoperative Day 1 helps reduce catheter removal time and length of hospital stay without increasing postoperative drainage or pain levels.

Objective:To explore the current status of lumbar paraspinal muscle functional exercise in patients undergoing lumbar fusion surgery, and to analyze the facilitators and barriers affecting these exercises in order to provide a theoretical basis for developing targeted interventions.Methods:This qualitative study was guided by the Information-Motivation-Behavioral Skills (IMB) model. Semi-structured interviews were conducted between September and November 2024 with 13 postoperative patients, 13 medical staff from the spine surgery ward, and four family caregivers at Beijing Jishuitan Hospital, Capital Medical University. Data were orgznized, analyzed and coded using Colaizzi's seven-step method.Results:A total of three major themes and 14 subthemes were identified. The first major theme highlighted various facilitating factors, including perceived benefits of rehabilitation, a trusting physician-patient relationship, strong motivation for recovery, and patient preference in exercise choices. The second major theme revealed several barriers, including residual postoperative symptoms, psychological burden, lack of awareness, limited access to information, uncomfortable experiences during exercise, and negative family support. The third major theme described the current issues of clinical implementation, including unclear role definitions among healthcare staff, inefficient exercise models, lack of standardized protocols and guidelines, and the need to establish a support and follow-up system.Conclusions:The implementation of lumbar paraspinal muscle functional exercises post-lumbar fusion surgery is influenced by multiple facilitating and hindering factors. Healthcare professionals should leverage facilitators and overcome barriers by adopting targeted strategies to optimize postoperative rehabilitation care practices.

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.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective To construct a predictive model for patients with verte-brobasilar dolichoectasia(VBD)complicated by posterior circulation acute cerebral infarction(ACI)based on the characteristics of verte-brobasilar artery magnetic resonance vascular wall imaging(MR-VWI),thereby providing a reference for clinical prevention.Methods A total of 102 patients with VBD complicated by posterior circulation ACI who were admitted to our hospital between March 2016 and January 2023 were selected as the concurrent group.An addi-tional 102 patients with VBD without concurrent posterior circulation ACI were selected as the non-concurrent group at a 1∶1 ratio.The MR-VWI characteristics(basilar artery[BA]diameter,BA length,vertebral artery[VA]intracranial segment length,BA deviation grade,and BA bifurcation height grade)and clinical data of the two groups were compared,and the factors influencing posterior circulation ACI in patients with VBD were analyzed.Based on the MR-VWI features and related influencing factors,a nomogram prediction model of pos-terior circulation ACI in patients with VBD was constructed,and the clinical significance of the nomogram prediction model was evaluated using receiver operating characteristic(ROC)and calibration curves.Results A significant difference were observed in the D-dimer levels between the two groups(P＜0.05).BA diameter,BA length,and VA intracranial length were greater in the concurrent group than in the non-concurrent group.The proportion of BA bifurcation height grade ≥ 2 and BA deviation grade≥2 in the concurrent group was higher than that in the non-concurrent group(P＜0.05).BA diameter,BA length,BA bifurcation height classification,BA deviation classi-fication,and D-dimer level were all independent risk factors for posterior circulation ACI in patients with VBD(P＜0.05).The area under the curve of the posterior circulation ACI predicted using the nomogram model was 0.900(95％CI:0.858-0.943),and good calibration was noted.Conclusion BA diameter,BA length,BA bifurcation height classification,BA offset classification,and D-dimer level were inde-pendent influencing factors of posterior circulation ACI in patients with VBD.Based on these factors,a nomogram prediction model was constructed with high prediction efficiency and good calibration.

Objective To explore the predictive value of MRI parameters of carotid artery plaque combined with low density lipoprotein cholesterol/high density lipoprotein cholesterol(LDL-C/HDL-C)ratio for predicting ischemic stroke in young patients with carotid atherosclerosis.Methods Totally 125 young patients with carotid atherosclerosis were prospectively included and divided into stroke group and non-stroke group based on whether ischemic stroke occurred within 3 months.Clinical data,laboratory indicators and carotid plaque-related MRI parameters were compared between groups.Based on carotid plaque-related MRI parameters being statistically different between groups,combined model 1 was constructed using multivariable logistic regression analysis,while combined model 2 was constructed combined with LDL-C/HDL-C ratio.The efficacy of each parameter and model for predicting ischemic stroke in young adults was analyzed.Results There were 48 cases in stroke group and 77 cases in non-stroke group.The levels of glycosylated hemoglobin,LDL-C,LDL-C/HDL-C ratio,carotid artery stenosis rate,plaque eccentricity index and plaque enhancement rate in stroke group were all higher than those in non-stroke group(all P＜0.05).The area under the curve(AUC)of LDL-C/HDL-C ratio,carotid artery stenosis rate,plaque eccentricity index,plaque enhancement rate,combined model 1 and 2 for predicting ischemic stroke in young adults was 0.816,0.757,0.768,0.805,0.883 and 0.936,respectively,of combined model 1 was higher than those of single parameter(all P＜0.05),while of combined model 2 was higher than that of combined model 1(Z=2.336,P=0.020).Conclusion MRI parameters of carotid artery plaque combined with LDL-C/HDL-C ratio could effectively predict ischemic stroke in young patients with carotid atherosclerosis.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective:To investigate the current status of postoperative Day 1 ambulation in patients undergoing posterior lumbar interbody fusion (PLIF) surgery under an enhanced recovery after surgery (ERAS) protocol, analyze the influencing factors of successful ambulation on postoperative Day 1, and explore the impact of early ambulation on postoperative recovery.Methods:Data from 397 patients who underwent PLIF surgery at Beijing Jishuitan Hospital, Capital Medical University, from September 2023 to July 2024 were retrospectively collected. Patients were divided into two groups based on whether they successfully ambulated on postoperative Day 1: the successful ambulation on Day 1 group and the delayed ambulation group. Binary Logistic regression was used to analyze the factors influencing successful ambulation on postoperative Day 1. Postoperative recovery indicators, including catheter removal time, hospital length of stay, drainage volume on postoperative Day 3, and pain scores for the low back and legs, were compared between the two groups.Results:A total of 378 patients were included in the analysis. Among them, 316 patients (83.6%) successfully ambulated on postoperative Day 1, while 62 patients (16.4%) had delayed ambulation. Logistic regression analysis indicated that postoperative Day 1 hemoglobin classification and pre-ambulation low back pain score in the supine position were independent factors influencing successful ambulation on Day 1 ( P<0.05). The successful ambulation group had a shorter catheter removal time and hospital stay compared to the delayed ambulation group, with statistically significant differences ( P<0.05). There were no significant differences between the two groups in postoperative drainage volume, low back pain scores, leg pain scores, or Oswestry Disability Index scores before discharge (all P>0.05) . Conclusions:Postoperative Day 1 hemoglobin levels and pre-ambulation low back pain scores are independent factors influencing the success of ambulation on postoperative Day 1 in patients undergoing PLIF surgery. Early ambulation on postoperative Day 1 helps reduce catheter removal time and length of hospital stay without increasing postoperative drainage or pain levels.

Objective:To explore the current status of lumbar paraspinal muscle functional exercise in patients undergoing lumbar fusion surgery, and to analyze the facilitators and barriers affecting these exercises in order to provide a theoretical basis for developing targeted interventions.Methods:This qualitative study was guided by the Information-Motivation-Behavioral Skills (IMB) model. Semi-structured interviews were conducted between September and November 2024 with 13 postoperative patients, 13 medical staff from the spine surgery ward, and four family caregivers at Beijing Jishuitan Hospital, Capital Medical University. Data were orgznized, analyzed and coded using Colaizzi's seven-step method.Results:A total of three major themes and 14 subthemes were identified. The first major theme highlighted various facilitating factors, including perceived benefits of rehabilitation, a trusting physician-patient relationship, strong motivation for recovery, and patient preference in exercise choices. The second major theme revealed several barriers, including residual postoperative symptoms, psychological burden, lack of awareness, limited access to information, uncomfortable experiences during exercise, and negative family support. The third major theme described the current issues of clinical implementation, including unclear role definitions among healthcare staff, inefficient exercise models, lack of standardized protocols and guidelines, and the need to establish a support and follow-up system.Conclusions:The implementation of lumbar paraspinal muscle functional exercises post-lumbar fusion surgery is influenced by multiple facilitating and hindering factors. Healthcare professionals should leverage facilitators and overcome barriers by adopting targeted strategies to optimize postoperative rehabilitation care practices.

Given the lack of annotations for key lung organs and tissues in existing public datasets,this study collected 863 cases of chest CT scan images and constructed the first comprehensive dataset containing annotations of pulmonary vessels,airways,and nodules using a semi-automated method that combines computer vision algorithms with manual corrections by radiologists.On this basis,a lung nodule segmentation model based on multi-task learning is proposed.By incorporating annotations of pulmonary vessels(pulmonary arteries and veins)and the trachea to enhance model's ability to learn lung features,the proposed model reduces the false discovery rate in lung nodule detection,and improves generalization ability.Additionally,the use of larger image patches further optimizes model performance.The trained VAAN_128 model achieves the best performance,with a Dice coefficient of 0.694 and a false discovery rate of 0.210 for lung nodule segmentation.Moreover,it simultaneously provides accurate segmentation results of pulmonary vessels and the trachea,assisting in the formulation of more precise diagnosis and treatment plans.Based on the VAAN_128 model,a software system for navigation and localization in biopsy procedures is developed.In clinical practice,this system can assist physicians in accurately locating lung nodules,distinguishing critical tissues,and improving preoperative planning efficiency.This provides precise and efficient technical support for early diagnosis and disease monitoring of lung diseases,and is of great significance for path planning in clinical navigation system and future lung imaging research.