For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective:To investigate the effect and mechanism of total glucosides of paeony(TGP)on intestinal ischemia reperfusion(IIR)injury in rats based on Ras homolog gene family member A(RhoA)/Rho-related coiled-coil protein kinase 1(Rock1)pathway.Method:The IIR rat models were established by clamping the superior mesenteric artery for 1 h,and the rats were randomly divided into Sham group,Model group,TGP group,TGP+Rhosin(RhoA inhibi-tor)group and TGP+LPA(RhoA agonistor)group,with 8 rats in each group.After 4 weeks of continuous administration once a day,the activity or level of intestinal barrier indexes[diamine oxidase(DAO),d-lactic acid(D-LA)and endotoxin(ET)]in plasma were detected by ELISA method,the wet/dry weight(W/D)ratio was calculated to evaluate the intestinal water content.The intestinal histopathological changes was observed by HE stainning,and the the degree of intestinal injury was evaluated by Chiu's score.The intestinal cells apoptosis was observed by TUNEL method.The inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-18(IL-18)and interleukin-1β(IL-1β)]in serum were detected by ELISA method.The oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)and catalase(CAT)]in serum were measured by spectrophotometry method.The expression of RhoA,ROCK1,nuclear factor-κB p65(NF-κB p65),hypoxia induciblefactor-1α(HIF-1α),zonula occludens protein-1(ZO-1),Occludin proteins were detected by Western blot method.Result:Compared with Model group,the activity of DAO and the content of D-LA,ET in plasma of TGP group and TGP+Rhosin group were significantly decreased,the W/D of intestinal were significantly decreased(P<0.05).The intestinal histopathological changes were significantly improved,the Chiu's score and cell poptosis index were significantly decreased(P<0.05).The content of TNF-α,IL-18,IL-1β,MDA in serum were significantly decreased,the activity of SOD,CAT were significantly increased(P<0.05).The expression of RhoA,ROCK1,NF-κB p65 proteins in in-testine tissue were significantly decreased,the expression of HIF-1α,ZO-1,Occludin proteins were significantly in-creased(P<0.05).Compared with TGP group,Rhosin significantly enhanced the effects of TGP on various detection indi-cators in IIR rats(P<0.05),while LPA significantly weakened the aforementioned effects of TGP(P<0.05).Conclusion:TGP could inhibiting inflammation,oxidative stress and improving intestinal barrier function by down-regulating RhoA/ROCK1 pathway,thus playing protective role against IIR injury in rats.

Objective To establish a stable,reliable,and clinically relevant porcine model of endotoxin-induced acute respiratory distress syndrome(ARDS).Methods Ten 8-month-old male Bama minipigs were deeply sedated,followed by invasive mechanical ventilation and electrocardiographic monitoring.Lipopolysaccharide(LPS)was intravenously pumped at 600 μg/(kg·h)for 3 hours,then maintained at 15 μg/(kg·h)thereafter.Dynamic monitoring was performed at five time points after LPS injection(LPS 0,1,3,5,and 8 h),including arterial blood gas analysis and chest computed tomography(CT)scans.Pathological examination of lung tissues obtained via bronchoscopic biopsy(HE staining and transmission electron microscopy)was conducted.These indicators were comprehensively used to evaluate the success of the animal model.Results At 5 hours after LPS administration,8 minipigs developed symptoms such as skin cyanosis,elevated body temperature,and respiratory distress.The oxygenation index decreased to<300 mmHg.Chest CT scans showed diffuse pulmonary infiltrates.Histopathology revealed alveolar edema and hyaline membrane formation.Transmission electron microscopy demonstrated disruption of pulmonary blood-air barrier,depletion of lamellar bodies in type Ⅱ pneumocytes,inflammatory cell infiltration,and exudation of plasma proteins and fibrin.Compared with LPS 0 h,at LPS 8 h,the oxygenation index and arterial blood pH were significantly decreased(P<0.001),while blood lactic acid and serum potassium were significantly increased(P<0.05);serum calcium and base excess were significantly decreased(P<0.05),and the lung injury score based on HE-stained lung sections was significantly increased(P<0.01).Conclusion The porcine ARDS model established by continuous LPS injection can dynamically simulate the pathophysiological characteristics and typical pathological manifestations of clinical septic ARDS,making it an effective tool to study the pathogenesis,prevention,and treatment strategies of septic ARDS.

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.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective:To investigate the effect and mechanism of total glucosides of paeony(TGP)on intestinal ischemia reperfusion(IIR)injury in rats based on Ras homolog gene family member A(RhoA)/Rho-related coiled-coil protein kinase 1(Rock1)pathway.Method:The IIR rat models were established by clamping the superior mesenteric artery for 1 h,and the rats were randomly divided into Sham group,Model group,TGP group,TGP+Rhosin(RhoA inhibi-tor)group and TGP+LPA(RhoA agonistor)group,with 8 rats in each group.After 4 weeks of continuous administration once a day,the activity or level of intestinal barrier indexes[diamine oxidase(DAO),d-lactic acid(D-LA)and endotoxin(ET)]in plasma were detected by ELISA method,the wet/dry weight(W/D)ratio was calculated to evaluate the intestinal water content.The intestinal histopathological changes was observed by HE stainning,and the the degree of intestinal injury was evaluated by Chiu's score.The intestinal cells apoptosis was observed by TUNEL method.The inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-18(IL-18)and interleukin-1β(IL-1β)]in serum were detected by ELISA method.The oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)and catalase(CAT)]in serum were measured by spectrophotometry method.The expression of RhoA,ROCK1,nuclear factor-κB p65(NF-κB p65),hypoxia induciblefactor-1α(HIF-1α),zonula occludens protein-1(ZO-1),Occludin proteins were detected by Western blot method.Result:Compared with Model group,the activity of DAO and the content of D-LA,ET in plasma of TGP group and TGP+Rhosin group were significantly decreased,the W/D of intestinal were significantly decreased(P<0.05).The intestinal histopathological changes were significantly improved,the Chiu's score and cell poptosis index were significantly decreased(P<0.05).The content of TNF-α,IL-18,IL-1β,MDA in serum were significantly decreased,the activity of SOD,CAT were significantly increased(P<0.05).The expression of RhoA,ROCK1,NF-κB p65 proteins in in-testine tissue were significantly decreased,the expression of HIF-1α,ZO-1,Occludin proteins were significantly in-creased(P<0.05).Compared with TGP group,Rhosin significantly enhanced the effects of TGP on various detection indi-cators in IIR rats(P<0.05),while LPA significantly weakened the aforementioned effects of TGP(P<0.05).Conclusion:TGP could inhibiting inflammation,oxidative stress and improving intestinal barrier function by down-regulating RhoA/ROCK1 pathway,thus playing protective role against IIR injury in rats.

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.

In order to improve the poor photostability of nifedipine, this study designed a cocrystal based on the principles of crystal engineering and prepared nifedipine-imidazole cocrystal by suspension method. The new cocrystal was characterized by powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC), thermogravimetric analysis (TG) and infrared spectroscopy (IR) to confirm the formation of the cocrystal. The photostability of nifedipine and its cocrystal was measured by powder X-ray diffraction and high-performance liquid chromatography (HPLC). The results showed that the nifedipine-imidazole cocrystal improved the photostability of nifedipine to a certain extent. This study provides guidance for the development of nifedipine cocrystals and the improvement of its druggability.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Aim To preliminarily evaluate the effects of hypobaric hypoxia on organism damage in rats with post-traumatic stress disorder(PTSD),with a view to laying a foundation for drug research in plateau PTSD.Methods The rats were randomly divided into four groups,namely,the control(Control)group,the sin-gle-prolonged stress(SPS)group,the hypobaric hy-poxia(HH)group and the single-prolonged stress combined with hypobaric hypoxia(SPS+HH)group.The PTSD model was firstly constructed using the SPS method for rats in the SPS and SPS+HH groups.On the second day,rats in the HH group and SPS+HH group were placed in a low-pressure hypoxia chamber at a simulated altitude of 6000 m for 14 days.General condition,behavior,blood tests,and histomorphology were examined in order to evaluate the damage caused by low pressure hypoxia in PTSD rats.Results The body mass of rats in the SPS+HH group was signifi-cantly reduced;the feces were partly hard and lumpy,and some of them were seen to have high viscosity.Anxiety-like and depression-like behaviors were ob-served in all groups except in the control group,in which hypobaric hypoxia aggravated the behavioral ab-normalities in SPS rats.Rats in both the SPS and SPS+HH groups had coagulation dysfunction and abnor-mally increased blood viscosity,which was significantly abnormal in the SPS+HH group;erythrocytes,hemo-globin,and erythrocyte specific volume in whole blood of rats in the SPS+HH group were significantly in-creased compared with those of rats in the SPS group;and serum TP,LDH and GLU levels were abnormal in rats in the SPS+HH group.Dilated and congested blood vessels were seen in hippocampal tissue,conges-ted central veins were seen in hepatic tissue,and dilat-ed and congested liver sinusoids with mild granuloma-tous degeneration of hepatocytes were seen in rats of the SPS+HH group.Conclusion Hypobaric hypoxia exacerbates depression-like and anxiety-like behaviors in PTSD rats,as well as hematological indices and his-tomorphometric abnormalities in PTSD rats.