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.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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OBJECTIVETo investigate the inhibitory effect of von Willebrand factor-cleaving protease, a disintegrin-like and metalloprotease with thrombospondin-1 repeats (ADAMTS13)on angiogenesis induced by vascular endothelial growth factor (VEGF)in vitro and in vivo.

METHODSCell proliferation assay, differentiation (tube formation)assay and wound migration assay were performed by using human umbilical vein endothelial cells (HUVECs)to explore the effect of ADAMTS13 on angiogenesis in vitro. Cells were treated with different concentrations of ADAMTS13 (1, 5, 25, 50 and 100 nmol/L)and the number of cells was counted via MTT assay. In addition, effect of ADAMTS13 on differentiation was assessed by measuring the length of capillary-like tube structures formed by HUVECS in matrigel. Effect of ADAMTS13 on HUVEC migration was assessed via calculation of wound healing distance after 8 hrs culture with VEGF or ADAMTS13. Chick embryo chorioallantoic membrane (CAM) assay and Matrigel plug assay were performed to investigate the effect of ADAMTS13 on angiogenesis in vivo.

RESULTSADAMTS13 significantly inhibited the proliferation of HUVECs induced by VEGF in a dose-dependent manner. Migration distance of HUVECs was (79 ± 22) μm in control group, (250 ± 8)μm in VEGF-treated group and (170 ± 23)μm in VEGF and ADAMTS13 cotreated-group after 8 hrs, respectively. The tube length is (450.6 ± 16.6)% in VEGF-treated group and (235.3 ± 19.0)% in VEGF and ADAMTS13 cotreated-group of that of control group after HUVECs cultured in matrigel for 16 hrs. The number of blood vessels decreased after treatment with ADAMTS13 in CAM assay. The number of blood vessels was (228.2 ± 10.8)%, (69.2 ± 21.1)%, (184.6 ± 15.2)% in VEGF treated-group, ADAMTS13 treated-group and VEGF and ADAMTS13 cotreated-group of that of control group, respectively. Formation of capillary-like network in matrigel plugs containing VEGF was reduced to 43.5% by ADAMTS13 in matrigel plug assay in mouse model.

CONCLUSIONADAMTS13 inhibits the HUVECs proliferation, differentiation and migration in vitro. ADAMTS13 inhibits chick embryos vascularization and formation of capillary-like network in vivo.

ADAM Proteins ; pharmacology ; ADAMTS13 Protein ; Animals ; Cell Movement ; Cell Proliferation ; Chick Embryo ; Chorioallantoic Membrane ; Collagen ; Drug Combinations ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; Laminin ; Mice ; Neovascularization, Physiologic ; Proteoglycans ; Vascular Endothelial Growth Factor A

Objective To evaluate two methods of selecting region of interest (ROI)to measure the apparent diffusion coefficient (ADC)of breast lesions on diffusion-weighted imaging (DWI).Methods MRI findings (including plain MRI,dynamic contrast-en-hanced MRI and DWI)of 5 3 cases with breast mass confirmed by pathology were analyzed retrospectively.Two observers independ-ently measured the ADC of breast lesions by the method of fixed ROI with the size of 10 mm2 ±2 mm2 and the routine method.The mean ADCs of benign and malignant breast lesions were compared between two methods and two observers by using paired samples T-test.The values of ADC diagnosing breast cancer were compared between the two methods by using the receiver operating charac-teristic (ROC)curve.Results Among 62 lesions of 53 cases,33 lesions were malignant,and 29 lesions were benign.For the first observer,the mean ADCs of benign and malignant lesions were (1.647±0.359)×10-3 mm2/s and (1.136±0.227)×10-3 mm2/s measured by the fixed ROI method,respectively.The area under the ROC was 0.897.The mean ADCs of benign and malignant le-sions were (1.603±0.415)×10-3mm2/s and (1.251±0.237)×10-3 mm2/s measured by the routine method,respectively.The area under the ROC was 0.768.For another observer,the mean ADCs of benign and malignant lesions were (1.647±0.357)× 10-3 mm2/s and (1.130±0.250)×10-3 mm2/s measured by the fixed ROI method,respectively.The mean ADCs of benign and malignant lesions were (1.590± 0.390)×10-3 mm2/s and (1.250±0.237)×10-3 mm2/s measured by the routine method,respec-tively.There was no significant difference for the mean ADC of benign lesions between the two methods.However,there was sig-nificant difference for the mean ADC of malignant lesions between the two methods.The diagnostic value of ADC measured by the fixing method was better than that of the routine method (P=0.008).There were no significant differences for ADCs of benign and malignant lesions between the two observers.Conclusion DWI has an important value for differential diagnosis of benign and malignant breast lesions.The measurement of ADC by the fixed and smaller ROI is better than that by the routine ROI for dis-tinguishing malignant from benign breast lesions.