Objective To investigate the relationship between serum CXC chemokine ligand 1(CXCL1)and positive regulatory zone zinc finger protein 5(PRDM5)levels and lymph node metastasis of progressive gastric cancer and to analyze their predictive value for patients'prognosis.Methods 203 patients with progressive gastric cancer diagnosed in our hospital from June 2020 to March 2023 were selected and divided into the lymph node metastasis group(n=90)and the no-lymph node metastasis group(n=113)based on the presence or absence of lymph node metastasis,and the differences in the general information of the two groups were analyzed and compared,and the diagnostic value of CXCL1 and PRDM5 in lymph node metastasis of progressive gastric cancer was analyzed by plotting the ROC curve.Logistic regression was used to analyze the risk factors of lymph node metastasis in patients with progressive gastric cancer.Follow up for 2 years,draw Kapan Meier curves to compare the prognosis of patients with advanced gastric cancer lymph node metastasis at different levels of CXCL1 and PRDM5.Results The CXCL1 level in the lymph node metastasis group was higher than that in the no-lymph node metastasis group,and its PRDM5 level was lower than that in the no-lymph node metastasis group(P<0.05).The AUCs for diagnosing lymph node metastasis of progressed gastric cancer were 0.755 and 0.844 for CXCL1 and PRDM5,respectively,and the AUC for the combination of the two was 0.898(95%CI 0.848～0.936).The sensitivity and specificity were 88.89%and 77.88%,respectively(P<0.05).Tumor size,differentation degree,serum CEA,serum CA19-9,CXCL1,and PRDM5 levels were all risk factors for lymph node metastasis in patients with progressive gastric cancer(P<0.05).The survival time of patients with CXCL1>96.13 pg/mL is(15.13±0.85)months,while the survival time of patients with CXCL1≤96.13 pg/mL is(19.06±0.66)months.The survival time of patients with CXCL1≤96.13 pg/mL is longer than that of patients with CXCL1>96.13 pg/mL(P<0.05).The survival time of patients with PRDM>100.85 pg/mL is(18.62±0.69)months,while the survival time of patients with PRDM≤100.85 pg/mL is(14.60±0.78)months.The survival time of patients with PRDM>100.85 pg/mL is longer than that of patients with PRDM≤100.85 pg/mL(P<0.05).Conclusion The abnormal expression of CXCL1 and PRDM5 is related to lymph node metastasis in patients with progressive gastric cancer,and the combined detection of the two is of high value in the assessment of lymph node metastasis and prognosis in patients with progressive gastric cancer.

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.

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.

Objective To investigate the relationship between serum CXC chemokine ligand 1(CXCL1)and positive regulatory zone zinc finger protein 5(PRDM5)levels and lymph node metastasis of progressive gastric cancer and to analyze their predictive value for patients'prognosis.Methods 203 patients with progressive gastric cancer diagnosed in our hospital from June 2020 to March 2023 were selected and divided into the lymph node metastasis group(n=90)and the no-lymph node metastasis group(n=113)based on the presence or absence of lymph node metastasis,and the differences in the general information of the two groups were analyzed and compared,and the diagnostic value of CXCL1 and PRDM5 in lymph node metastasis of progressive gastric cancer was analyzed by plotting the ROC curve.Logistic regression was used to analyze the risk factors of lymph node metastasis in patients with progressive gastric cancer.Follow up for 2 years,draw Kapan Meier curves to compare the prognosis of patients with advanced gastric cancer lymph node metastasis at different levels of CXCL1 and PRDM5.Results The CXCL1 level in the lymph node metastasis group was higher than that in the no-lymph node metastasis group,and its PRDM5 level was lower than that in the no-lymph node metastasis group(P<0.05).The AUCs for diagnosing lymph node metastasis of progressed gastric cancer were 0.755 and 0.844 for CXCL1 and PRDM5,respectively,and the AUC for the combination of the two was 0.898(95%CI 0.848～0.936).The sensitivity and specificity were 88.89%and 77.88%,respectively(P<0.05).Tumor size,differentation degree,serum CEA,serum CA19-9,CXCL1,and PRDM5 levels were all risk factors for lymph node metastasis in patients with progressive gastric cancer(P<0.05).The survival time of patients with CXCL1>96.13 pg/mL is(15.13±0.85)months,while the survival time of patients with CXCL1≤96.13 pg/mL is(19.06±0.66)months.The survival time of patients with CXCL1≤96.13 pg/mL is longer than that of patients with CXCL1>96.13 pg/mL(P<0.05).The survival time of patients with PRDM>100.85 pg/mL is(18.62±0.69)months,while the survival time of patients with PRDM≤100.85 pg/mL is(14.60±0.78)months.The survival time of patients with PRDM>100.85 pg/mL is longer than that of patients with PRDM≤100.85 pg/mL(P<0.05).Conclusion The abnormal expression of CXCL1 and PRDM5 is related to lymph node metastasis in patients with progressive gastric cancer,and the combined detection of the two is of high value in the assessment of lymph node metastasis and prognosis in patients with progressive gastric cancer.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

OBJECTIVE To analyze the status quo ，influential factors of medication compliance and adverse drug reactions of home-based patients with severe mental disorders . METHODS Patients with severe mental disorders at home who were enrolled in the Shanghai mental health information management system in Jinshan district of Shanghai in Jan . 2022 were selected as the research objects . In combination with the relevant basic data registered in the information system and through face -to-face or telephone surveys by mental health doctors ，basic information ，medication compliance ，mental symptoms ，social function defects ， drug use information and adverse drug reactions of patients were understood . Univariate and multivariate Logistic regression analysis of medication compliance were performed . RESULTS Totally 2 684 questionnaires were distributed and 2 606 valid questionnaires were recovered ，with an effective recovery rate of 97.10%. The overall medication compliance of patients with severe mental disorders at home was 68.11%. The results of multivariate Logistic regression analysis showed that 51-60 years old ，unmarried， divorced or widowed ，partial social function defects ，no social function defects ， and use of third -generation antipsychotic drugs were the promotion factors of medication compliance ， （P＜0.05）；medical insurance ，non participation in work ，total number of hospitalizations of 1-4 times，total number of hospitalizations ≥ 5 times，general mental symptoms ，and use of second -generation antipsychotic drugs were the obstacles to medication compliance （P＜0.05）. The incidence of adverse drug reactions in patients with severe mental disorders a t home was 10.59%，mainly caused by second -generation antipsychotic drugs，and no new and serious adverse reactions were reported . CONCLUSIONS The medication compliance of patients with severe mental disorders at home is affected by many factors . It is urgent to need pharmacists ’participation to promote the standardization and rationality of patients ’medication.

OBJECTIVE： To provide theoretical basis and data support for community extended prescription management and pharmaceutical care. METHODS： Data of all patients using extended prescription from 2017 to 2018 were derived from the health information system database of Jinshan district of Shanghai and 11 streets towns under its jurisdiction. Retrospective survey was used to analyze the basic medical information of extended prescription patients and the compliance with extended prescription execution （insisting on dispensing drugs through extended prescription within 2 years）， and the factors affecting compliance were analyzed. RESULTS： From 2017 to 2018， there were 4 835 patients with Jinshan district extended prescription， with prescribing rate （number of extended prescriptions/number of prescriptions） of 2.08％， mainly patients over 60 years old （4 038 cases， 83.51％） and patients with common chronic diseases [4 793 casetimes， 83.18％ （4 793/5 763）]； there was statistical significance in the prescribing rate of extended prescription among different streets and towns （P＜0.05）. The overall compliance rate of extended prescription patients in Jinshan district was 81.62％ （62.02％-88.84％）. There was no significant difference in compliance rate of extended prescription execution between male and female patients （P＞0.05）. Age， type of disease and types of extended prescription drugs had influence on compliance rate of extended prescription patients. Compliance rate of extended prescription in patients under 40 years of age or hypertension and chronic airway disease or those who were given one kind of drug was lower than other patients in same group （P＜0.05）. CONCLUSIONS： Big data can be used for monitoring the compliance of extended prescription in the future. At the same time， pharmacists participating in family doctor team formulate relevant guidance and education for poor compliance group so as to improve the rationality and effectiveness of extended prescription for patients.

Objective To explore the feasibility and effect of 3D modeling and printing technology in constructing bone fracture models and assisting clinical teaching at the department of traumatic orthope-dics. Methods CT scan images of bone fractures were reconstructed by Mimics software. The digital 3D bone fracture models were constructed and the interactive multimedia teaching videos were output. More-over, all bone fracture models were printed by using fusion deposition modeling (FDM). At the end of the teaching course, a questionnaire survey was conducted to evaluate the teaching effect. Results The digital models of common bone fractures at the department of traumatic orthopedics were established, and the in-teractive multimedia teaching videos were output. A traumatic orthopedic teaching model with a 1∶1 scale was printed out. The questionnaire survey indicated that the application of 3D modeling and printing tech-nology to build bone fracture model with PPT teaching can obviously improve students' understanding and mastery of relevant theoretical knowledge. They helped students better remember the type of bone fractures and how to choose the correct internal fixation methods. The teaching effect was satisfactory. Conclusions 3D modeling and printing technology was applied to build bone fracture models to assist clinical teaching at the department of traumatic orthopedics. It was found that the printed 3D bone fracture models can stimulate students' enthusiasm for learning and improve their learning effect. This method has good application value.

OBJECTIVETo use combined G-banding and array-comparative genomic hybridization (aCGH) for the prenatal diagnosis of a fetus with 5q35 deletion syndrome.

METHODSChromosomal karotypes of the fetus and parents were analyzed with G-banding analysis. aCGH was performed to detect minor chromosomal structural abnormalities.

RESULTSThe karyotype of the fetus was ascertained as 46, XY, t(5;10)(q35;p13), and the karyotypes of the parents were normal. aCGH has identified a de novo 1.68 Mb deletion at 5q35.2q35.3 and a 1.44 Mb duplication at 10p14p13.

CONCLUSIONaCGH has a higher resolution and greater accuracy for mapping chromosomal aberrations and is a useful supplement for G banding karyptyping analysis.

Adult ; Chromosome Banding ; Chromosome Deletion ; Chromosomes, Human, Pair 5 ; genetics ; Comparative Genomic Hybridization ; Cri-du-Chat Syndrome ; diagnosis ; embryology ; genetics ; Female ; Fetal Diseases ; diagnosis ; genetics ; Humans ; Karyotyping ; Male ; Prenatal Diagnosis ; Trisomy ; diagnosis ; genetics

OBJECTIVETo explore the possible roles of polymorphisms of SPO11 and glutathionine S-transferase (GST) genes in idiopathic male infertility in a ethnic Han Chinese population from Henan.

METHODSMultiplex PCR and DNA sequencing were performed to determine the SPO11 c.517C>T(rs28368082) and GST genes (GSTM1, GSTT1, GSTP1) polymorphisms in 216 idiopathic male infertility cases and 198 normal samples.

RESULTSThe frequencies of the SPO11 CC and CT genotypes were 87.5% (189/216) and 12.5% (27/216) in the patients, and 97.5% (193/198) and 2.5% (5/198) in the controls, respectively. The frequencies of SPO11 CC and CT genotypes, the A>G transition at nucleotide 313 in the exon 5 of the GSTP1 gene, and the frequencies of combined genotypes GSTM1 (-/-), GSTT1 (+/+), GSTP1 (AA) and SPO11 (CT) were significantly different between the two groups (P<0.05).

CONCLUSIONThe rs28368082 polymorphism of the SPO11 gene, the A>G transition at nucleotide 313 in the exon 5 of the GSTP1 gene, and the combined genotypes of GSTM1 (-/-), GSTT1 (+/+), GSTP1 (AA) and SPO11 (CT) may be associated with idiopathic male infertility in ethnic Han Chinese.

Adult ; Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Endodeoxyribonucleases ; genetics ; Gene Frequency ; Genetic Predisposition to Disease ; ethnology ; genetics ; Genotype ; Glutathione S-Transferase pi ; genetics ; Glutathione Transferase ; genetics ; Humans ; Infertility, Male ; enzymology ; ethnology ; genetics ; Linkage Disequilibrium ; Male ; Mutation ; Odds Ratio ; Polymorphism, Genetic ; Sequence Analysis, DNA