Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

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.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

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.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate the precision of robot-assisted axis pedicle screw placement and to evaluate the factors influencing the accuracy of the placement.Methods:The medical records of 27 consecutive patients who underwent posterior internal fixation of the upper cervical spine for atlantoaxial instability with intraoperative robot-assisted axis pedicle screw placement from January 2017 to December 2020 at Beijing Jishuitan Hospital were retrospectively analyzed. T The cohort comprised 10 males and 17 females, aged 41.3±16.6 years (range 12-75 years), with a body mass index (BMI) of 23.0±2.9 kg/m 2 (range 18.9-30.0 kg/m 2). There were 16 cases of traumatic atlantoaxial instability and 11 cases of atlantoaxial instability caused by deformity. The accuracy of robot-assisted axis pedicle screw placement was evaluated by postoperative CT using Gertzbein-Robbins scale. Factors potentially affecting placement accuracy were initially identified via univariate analysis, with significant factors ( P<0.200) subsequently analyzed through multivariate modeling using generalized estimating equations. Results:A total of 49 axis pedicle screws were placed in 27 patients, with 35 (71.4%) in Gertzbein-Robbins scale grade A, 12 (24.5%) in grade B, 2 (4.1%) in e grade C, and 0 in grades D and E. The clinically acceptable rate (Gertzbein-Robbins grades A and B) was 95.9%. No patient experienced vascular or neurologic injury due to screw displacement. The results of univariate analysis showed no statistical significance for patient factors (age, gender, BMI, preoperative cervical curvature, and causes of atlantoaxial instability); no statistical significance for the surgical factors of tracker position, screw position, screw type, and screw placement approach ( P>0.05), and a statistically significant difference for the difference between the effective width of the axis pedicle and the screw diameter ( t=3.484, P<0.001). The results of multifactorial analysis showed that tracker fixation to the Mayfield frame in robot-assisted axis pedicle screw placement over the axis spinous process resulted in more accurate screw placement [ OR=83.231, 95% CI(3.898, 1776.952), P=0.005]; and the greater the difference between the effective width of the axis pedicle and the diameter of the screw, the greater the accuracy of screw placement [ OR=5.330, 95% CI(1.648, 17.243), P=0.005]. Conclusion:Robot-assisted axis pedicle screw placement is both precise and safe. Securing the tracker to the Mayfield clamp rather than the axis spinous process enhances the accuracy of screw placement. A greater discrepancy between the axis pedicle's effective width and the screw diameter decreases the likelihood of cortical violation. Preoperative planning, including the selection of appropriate screw types and adjusting the trajectory in three dimensions to maximize the difference between the pedicle's effective width and the screw diameter, can mitigate the risk of cortical breach and subsequent vascular and neurological injury.

Objective:To investigate the efficacy and safety of Guihuang Formula(GHF)in the treatment of type Ⅲ prostatitis with the syndrome of damp-heat stasis in the essence chamber.Methods:This study included 120 cases of type Ⅲ prostatitis with damp-heat stasis syndrome in the essence chamber,which were randomly and equally divided into a GHF and a control group,the for-mer treated with GHF and the latter with Tamsulosin Hydrochloride Sustained-Release Capsules,both for 6 successive weeks.We fol-lowed up the patients for 4 weeks,recorded the NIH-CPSI,TCM symptom scores,and results of prostatic fluid routine,blood and u-rine routine,liver and kidney function and electrocardiogram examinations,and compared them between the two groups of patients be-fore and after treatment.Results:Compared with the baseline,the total NIH-CPSI scores were significantly decreased in both the GHF and control groups after 6 weeks of treatment,even more significantly in the former group(28.34±9.23 vs 6.78±3.53,P＜0.05)than in the latter(27.81±8.28 vs 14.48±4.27,P＜0.05),so were the scores on pain,voiding symptoms,quality of life(QOL)impact,TCM symptoms and WBC count(all P＜0.05),while the number of lecithin bodies remarkably increased(P＜0.05).There were statically significant differences in the above parameters at 4,6 and 10 weeks of medication(P＜0.05),but not at 2 weeks(P＞0.05).No obvious abnormalities or adverse reactions were observed in either of the two groups during the treatment.Conclusion:Guihuang Formula is safe and effective in the treatment of type Ⅲ prostatitis with the syndrome of damp-heat stasis in the essence chamber.

The pedicle screw internal fixation system plays a crucial role in spinal surgery, with the advantage of enhancing spinal stability. However, potential complications such as internal fixation loosening and screw pullout still exist clinically. Currently, pullout of strength is commonly used to evaluate the short-term biomechanical properties of internal fixation, fatigue test is performed to evaluate the long-term biomechanical properties of internal fixation, and torque is used to evaluate the interaction between screws and spinal bone. Factors that influence the biomechanical properties of pedicle screws include spine-related factors (bone density) and screw-related factors (screw size, screw design, and screw augmentation materials). In bones with high bone density, pullout of strength is significantly increased, and fixation strength can also be improved by increasing screw diameter and length, improving screw design, and using screw augmentation materials. Biomechanical research on pedicle screw internal fixation provides key information for achieving individualized and functional optimal channel selection. Designing screw channels with optimal fixation strength is expected to reduce the risk of screw loosening and the occurrence of surgical complications, and improve surgical effects.

This study was aimed at surveying the distribution of Himalayan marmots in Gaotai County,Zhangye City,Gan-su Province,and analyzing the risk of plague occurrence,to provide a scientific basis for plague prevention and control in the area.On the basis of preliminary evidence,we used a combined approach of on-site investigation and Global Positioning System(GPS)positioning to survey the distribution and natural geographical landscape characteristics of the Himalayan marmot in Gaotai County.Population information and customs in the marmot distribution area were investigated through methods such as data retrieval and household visits.Himalayan marmots were captured through bow-shaped trapping,and blood,liver,spleen,heart,lung,kidney,femur,and surface-intermediate host samples were collected.Pathological and serological tests were conducted according to the Plague Diagnosis Criteria(WS279-2008).In Xinba Town,Gaotai County,Himalayan marmots were found in 16 villages(53.33％).Heping Village had the largest distribution area(100％),and was followed by Zhaoyi Village(79.17％)and Xishang Village(55.32％),whereas the other areas had values below 50％.Regarding the direct threats posed by marmots,Heping Village,Dongda Vil-lage,and Zhaoyi Village had values of 100％,Xishang Village had a value of 90.59％,and the other areas had values below 50％.The flea infestation rate on marmots'bodies was 59.62％,and the flea index was 1.48％(77/52).The main surface-in-termediate hosts were steppe ticks,body lice,Xenopsylla siberica,and Nosopsyllus laeviceps,accounting for 72.31％(517/715),16.92％(121/715),6.43％(46/715),and 4.20％(30/715),respectively,with steppe ticks being the dominant species.A total of 52 liver and spleen tissue samples from marmots,and 715 surface-intermediate hosts samples,were collected for bacterial culture.No Yersinia pestis was found.RIHA testing for plague F1 antigen was negative in all samples.Additionally,52 blood serum samples from marmots were collected,and IHA testing for plague-specific F1 antibodies was negative in all samples.The natural plague foci of marmots in the Qilian Mountains and Altyn Mountains is affected by factors including con-tinuing increases in temperature and grassland degradation.As a result,the marmot plague hosts continually migrate to sur-rounding non-epidemic areas,particularly in Gaotai County,Zhangye City.Local residents often hunt wild rabbits and mar-mots,thus posing a risk of human plague outbreaks if animal plague occurs.This county is recommended to be included in the province's plague surveillance and epidemic source investigation.Additionally,efforts should be strengthened in health educa-tion,medical personnel training,and management of key individuals and emergency reserves.If necessary,protective measures should be taken in marmot and flea control,to prevent the occurrence and spread of plague.

This study was aimed at surveying the distribution of Himalayan marmots in Gaotai County,Zhangye City,Gan-su Province,and analyzing the risk of plague occurrence,to provide a scientific basis for plague prevention and control in the area.On the basis of preliminary evidence,we used a combined approach of on-site investigation and Global Positioning System(GPS)positioning to survey the distribution and natural geographical landscape characteristics of the Himalayan marmot in Gaotai County.Population information and customs in the marmot distribution area were investigated through methods such as data retrieval and household visits.Himalayan marmots were captured through bow-shaped trapping,and blood,liver,spleen,heart,lung,kidney,femur,and surface-intermediate host samples were collected.Pathological and serological tests were conducted according to the Plague Diagnosis Criteria(WS279-2008).In Xinba Town,Gaotai County,Himalayan marmots were found in 16 villages(53.33％).Heping Village had the largest distribution area(100％),and was followed by Zhaoyi Village(79.17％)and Xishang Village(55.32％),whereas the other areas had values below 50％.Regarding the direct threats posed by marmots,Heping Village,Dongda Vil-lage,and Zhaoyi Village had values of 100％,Xishang Village had a value of 90.59％,and the other areas had values below 50％.The flea infestation rate on marmots'bodies was 59.62％,and the flea index was 1.48％(77/52).The main surface-in-termediate hosts were steppe ticks,body lice,Xenopsylla siberica,and Nosopsyllus laeviceps,accounting for 72.31％(517/715),16.92％(121/715),6.43％(46/715),and 4.20％(30/715),respectively,with steppe ticks being the dominant species.A total of 52 liver and spleen tissue samples from marmots,and 715 surface-intermediate hosts samples,were collected for bacterial culture.No Yersinia pestis was found.RIHA testing for plague F1 antigen was negative in all samples.Additionally,52 blood serum samples from marmots were collected,and IHA testing for plague-specific F1 antibodies was negative in all samples.The natural plague foci of marmots in the Qilian Mountains and Altyn Mountains is affected by factors including con-tinuing increases in temperature and grassland degradation.As a result,the marmot plague hosts continually migrate to sur-rounding non-epidemic areas,particularly in Gaotai County,Zhangye City.Local residents often hunt wild rabbits and mar-mots,thus posing a risk of human plague outbreaks if animal plague occurs.This county is recommended to be included in the province's plague surveillance and epidemic source investigation.Additionally,efforts should be strengthened in health educa-tion,medical personnel training,and management of key individuals and emergency reserves.If necessary,protective measures should be taken in marmot and flea control,to prevent the occurrence and spread of plague.