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.

Objective To explore the application disturbance coefficient (DC) value of noninvasive brain edema monitoring in patients after traumatic brain injury.Methods A total of 54 cerebral injury patients were performed by non-invasive brain edema monitoring from June to November 2016.The essential information,DC,intracranial pressure (ICP),and 6-month-later glasgow outcome score (GOS) were collected.Results DC was negatively correlated with ICP (r=-0.779 5,P＜0.01),and it was positively correlated with glasgow coma scale (GCS) and GOS (r=0.667 5,P＜0.01;r=0.630 6,P＜0.01).The mean of DC with good prognosis patients was 106.99±4.09,and that of the poor prognosis patients was85.26±4.45,the difference was statistically significant (P＜0.05).Conclusion DC has a good clinical application value.

Objective To observe the effects of curcumin on B-type natriuretic peptide (BNP),cardiac troponin Ⅰ (cTnI) and D-dimer in rats with acute pulmonary embolism (APE).Methods The irregular cbemotactic factor (CX3CL1)-shRNA and overexpression vector were designed and synthesized,and adenovirus packages were respectively carried out.Sixty Spargue-Dawley (SD) rats were divided into normal control group,sham-operation group,model group,curcumin group,curcumin+CX3CL1-shRNA group and curcumin+CX3CL1 overexpression vector group by random number table (each group 10 rats).The APE rat models were duplicated by autologous blood embolus method.in the pharmacological intervention groups,1 day and again 40 minutes before operation,a dose of curcumin 100 mg/kg was administered by gavage respectively;in virus intervention groups,3 days before modeling,intravenous injection of 109 pfu into a tail vein was performed once;in sham-operation group and model group,an equivalent dose of normal saline 2 mL daily was administered by gavage;the normal group did not accept any intervention.Six hours after modeling,the change of lung tissue were observed under confocal laser scanning microscope,the lung tissue was taken for hematoxylin-eosin (HE) staining,histopathological changes of lung tissue were observed,and the levels of serum BNP,cTnI,D-dimer were detected by enzyme-linked immunosorbent assay (ELISA).Results Virus infected lung tissue was green,nucler was blue.The HE staining in lung tissue showed:histopathological changes in the model group were more obvious than those in normal group and sham-operation group,after curcumin intervention,some emboli in pulmonary arteries in all treatment groups were partially dissolved,and the inflammation was alleviated.The results of ELISA shows:the contents of cTnI,BNP,D-dimer were significantly higher in model group than those in shamoperation group [cTnI (ng/L):224.97 ± 37.96 vs.149.13 ± 36.65,BNP (ng/L):53.66 ± 21.72 vs.24.62 ± 10.44,D-dimer (ng/L):78.68 ± 13.10 vs.42.00 ± 9.30,all P ＜ 0.05];the contents of cTnI,BNP,D-dimer were significantly lower in curcumin group,curcumin+shRNA group and curcumin+CX3CL1 overexpression vector group than those in model group (cTnI was 162.98 ± 28.65,143.32 ± 34.55,159.50 ± 37.80 vs.204.97 ± 37.96,all P ＜ 0.05,BNP was 27.45 ± 11.00,26.95 ± 6.66,33.05 ± 7.05 vs.53.66 ± 21.72,all P ＜ 0.05,D-dimer was 54.34 ± 4.57,53.38 ± 11.01,56.33 ± 6.80 vs.78.68 ± 13.10,all P ＜ 0.05);there were no statistical significant differences in comparisons among all intervention groups (all P ＞ 0.05).Conclusion Curcumin is able to improve serum BNP,cTnI,D-dimer in APE rats,but its relation with CX3CL1 is not obvious.

Objective To investigate the correlation of serum lipoprotein(a)[Lp(a)]level and coronary artery lesion degree in elderly coronary heart disease (CAD) patients with type 2 diabetes mellitus.Methods 163 elderly patients with CAD in accordance with the control fasting glucose(FPG)levels on admission were divided into A,B,C three groups:FPG <6.1 mmol/L for group A(50 cases);6.1 mmol/L≤FPG <7.0 mmol/L for group B (69 cases);FPG >7.1 mmol/L for group C (44 cases).The clinical data,count in patients with coronary artery lesions and lesion severity index(Gensini score),blood lipid and lipoprotein(a)[Lp(a)],etc were recorded.Results There was significant difference in serum Lp(a)among three groups(F =21.577,P <0.001),the Lp(a)of group C [(413.5 ±63.1)mmol/L]was higher than group B[(376.3 ±58.3)mmol/L],group B was higher than group C [(335.3 ±52.5 )mmol/L].The differences of serum Lp (a)between coronary lesion groups were statistically significant(F =69.447,P <0.001),three lesion group Lp(a)[(436.6 ±60.2)mmol/L]was higher than the double branch lesions[(362.5 ±55.7 )mmol/L],double branch lesion group was higher than the single lesion group [(315.4 ±49.9)mmol/L];Gensini score between different coronary lesions group had significant differences (F =179.969,P <0.001),three lesion group Gensini score[(61.9 ±15.4)points]was higher than double branch lesion group[(34.3 ±12.5 )points],double branch lesion group was higher than the single lesion group [(17.2 ± 9.1)points];Lp(a)≥372.3 mmol/L group Gensini score[(58.4 ±12.5)points]was significantly higher than the Lp(a)<372.3 mmol/L group[(19.2 ±10.3)points](t =21.836,P <0.01);Lp(a)≥372.3 mmol/L group three lesions proportion(57.3%)was significantly higher than 18.5% of Lp(a)<372.3 mmol/L group(χ2 =37.142, P <0.001);Pearson correlation analysis showed that the serum level of Lp(a)was positively related with Gensini score(r =0.439,P <0.001 );Multiple linear regression analysis showed that the Lp(a)was the independent risk factors affecting the Gensini score(β=4.210,P <0.001).Conclusion In elderly patients with CAD 2 diabetes significantly higher serum levels of Lp(a),the higher level is closely related to the severity of coronary lesions,and can be used as an independent predictor of coronary artery lesion severity.

Objective To assess the influences of low-protein diet on the renal function and nutritional status in patients with stage 3/4 chronic kidney diseases (CKD).Methods Totally 34 patients with stage 3/4 CKD were randomly divided into group A (protein intake:0.6 g·kg~(-1)·d~(-1);n=14) and B (protein intake:0.8 g·kg~(-1)·d~(-1);n=20).Anthropometric measurement and blood biochemical tests were performed,nutri-tional status was assessed,and 24-hour dietary recall survey was conducted before and after the treatment.Patients were followed up for 6 months.Results In group A,the creatinine level significantly decreased (P=0.010),while albumin level (P=0.042) and the intake of energy (P=0.018) and carbohydrate (P<0.001) signifi-cantly increased after the treatment In all the 34 patients,in group A and group B,the malnutrition rates were de-creased by 14.7%,7.2%,and 21.1% after nutritional intervention.Conclusion The low-protein diet (protein intake 0.6 g·kg~(-1)·d~(-1)),in which part of the staple food was replaced by wheat starch,can increase the in-takes of carbohydrate and energy and improve renal function and nutritional status in patients with stage 3/4 CKD.