The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

OBJECTIVE: Cancer remains a significant global health challenge, necessitating the development of effective treatment approaches. Developing synergistic therapy can provide a highly promising strategy for anti-cancer treatment through combining the benefits of various mechanisms. METHODS: In this study, we developed a synergistic strategy for chemo-photothermal therapy by constructing nanocomposites using gold nanorods (GNRs) and tetrahedral framework nucleic acids (tFNA) loaded with the anti-tumor drug doxorubicin (DOX). RESULTS: Our in vitro studies have systematically clarified the anti-cancer behaviors of tFNA-DOX@GNR nanocomposites, characterized by their enhanced cellular uptake and proficient lysosomal escape capabilities. It was found that the key role of tFNA-DOX@GNR nanocomposites in tumor ablation is primarily due to their capacity to induce cytotoxicity in tumor cells via a photothermal effect, which generates instantaneous high temperatures. This mechanism introduces various responses in tumor cells, facilitated by the thermal effect and the integrated chemotherapeutic action of DOX. These reactions include the induction of endoplasmic reticulum stress, characterized by elevated reactive oxygen species levels, the promotion of apoptotic cell death, and the suppression of tumor cell proliferation. CONCLUSION This work exhibits the potential of synergistic therapy utilizing nanocomposites for cancer treatment and offers a promising avenue for future therapeutic strategies.
Doxorubicin/chemistry* ; Gold/chemistry* ; Nanotubes/chemistry* ; Humans ; Nanocomposites/chemistry* ; Cell Line, Tumor ; Nucleic Acids/chemistry* ; Antibiotics, Antineoplastic/pharmacology* ; Antineoplastic Agents/administration & dosage*

OBJECTIVE To design and synthesize mono-carbonyl curcumin analogues(MCACs)and investigate the activities of them against breast cancer.METHODS The analogues F1,F2,and F3 were obtained by aldol condensation reaction,and their antitumor activities(including the activities of human breast cancer cell MCF-7 and human lung cancer cell A549)were detected by MTT assay[evaluated with half inhibitory concentration(IC50)].The results of MTT assay were compared with those of curcumin.Bioinformatics methods were used to collect the core targets of analogues F1,F2 and F3 acting on breast cancer,and then molecular docking verification was carried out.The cell experiments were conducted to investigate the effects of high,medium and low concentrations(16,8,4 μmol/L)of F1,F2 and F3 on the expression of the first core target protein as well as the effects of medium concentration of F1,F2 and F3 on the expression of cleaved-caspase-3.RESULTS Compared with curcumin,IC50 of analogues F1,F2 and F3 to A549 and MCF-7 cells(except for IC50 of analogue F2 to A549 cells)were decreased significantly(P＜0.05 or P＜0.01);among them,IC50of analogue F2 to MCF-7 cell was the lowest,being(9.67±1.27)μmol/L.Bioinformatics analysis showed that index of affinity of analogues F1,F2 and F3 with the first core target epidermal growth factor receptor(EGFR),protein kinase B(AKT)and AKT were 5.909 2,8.402 5 and 6.486 6,respectively;high concentration of F1 could significantly reduce the phosphorylation level of EGFR protein in MCF-7 cells(P＜0.01),while low,medium,and high concentrations of F2 and high concentration of F3 could significantly reduce the phosphorylation level of AKT protein in MCF-7 cells(P＜0.05 or P＜0.01).Medium concentration of F1,F2,and F3 could significantly increase the expression level of cleaved-caspase-3 protein in MCF-7 cells(P＜0.01).CONCLUSIONS Designed and synthesized MCACs F1,F2 and F3 all have good anti-breast cancer activity,and F2 has better anti-breast cancer activity.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

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.

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.

Objective:To explore the clinical effects of various special forms of the descending branch of the lateral circumflex femoral artery (DLCFA) perforator flaps in repairing high-voltage electrical burn wounds on the wrist.Methods:This study was a retrospective observational study. From September 2014 to June 2024, 79 male patients with high-voltage electrical burns on the wrist, aged 20 to 62 years and met the inclusion criteria, were admitted to Beijing Jishuitan Hospital Affiliated to Capital Medical University, with wrist high-voltage electrical burn wound (hereinafter referred to as wrist wound) types being classified as type Ⅱ or type Ⅲ. In the early stage after injury, debridement was performed on the patients' wrists. Based on the wound condition and flap indications, the flow-through, lobed, chimeric, flow-through-lobed, lobed-chimeric, flow-through-chimeric, or flow-through-lobed-chimeric DLCFA perforator flap was employed individually, and the flow-through-chimeric DLCFA perforator flap and tensor fascia lata myocutaneous flap were employed in combination to repair the wounds. The donor site wounds were repaired using direct sutures or skin grafting. The number of various DLCFA perforator flaps resected during surgery and the number of various types of wrist wounds repaired were recorded, as well as the closure status of the donor site wound. The postoperative flap survival, occurrence of vascular crisis, wound or suture site healing, and patency of the reconstructed artery in flow-through flaps were recorded. During follow-up, the appearance of the flap, scar formation, and the presence of thigh muscle herniation were observed.Results:Intraoperatively, 11 flow-through DLCFA perforator flaps were resected to repair 11 type Ⅱ wrist wounds, 13 lobed DLCFA perforator flaps were resected to repair 9 type Ⅱ and 4 type Ⅲ wrist wounds, 16 chimeric DLCFA perforator flaps were resected to repair 16 type Ⅱ wrist wounds, 11 flow-through-lobed DLCFA perforator flaps were resected to repair 5 type Ⅱ and 6 type Ⅲ wrist wounds, 10 lobed-chimeric DLCFA perforator flaps were resected to repair 5 type Ⅱ and 5 type Ⅲ wrist wounds, 6 flow-through-chimeric DLCFA perforator flaps were resected to repair 6 type Ⅱ wrist wounds, 7 flow-through-lobed-chimeric DLCFA perforator flaps were resected to repair 7 type Ⅲ wrist wounds, and 5 flow-through-chimeric DLCFA perforator flaps combined with tensor fascia lata myocutaneous flaps were resected to repair 5 type Ⅲ wrist wounds. Seventy-four patients had their donor site wounds closed by direct suturing, while 5 patients had their donor site wounds closed by skin grafting. Postoperatively, the flaps in 3 patients developed vascular crisis, including 1 case of arterial crisis and 2 cases of venous crises but survived after emergency vascular exploration and other treatments; the remaining flaps survived completely. Postoperatively, 3 patients had seepage beneath their flaps, which were closed after dressing changes; the remaining patients' wounds or suture sites all healed. Anteriography showed that all reconstructed arteries in 35 patients who underwent flow-through flap transplantation were patent postoperatively. During the follow-up period of 3 months to 1 year, 20 patients had bloated flap, while the rest had good flap appearance; linear scars were left in the donor sites that underwent direct wound closure, and the skin-grafted areas of the donor site wounds showed no significant patchy hypertrophic scarring; no thigh muscle herniation occurred.Conclusions:Taking the full advantage of perforator flaps, various special forms of the DLCFA perforator flaps are used to repair the three-dimensionally injury wounds caused by high-voltage electrical burns on the wrist, which not only minimizes the damage to the donor site but also allow the recipient site to be well repaired, showing good appearance in the recent follow-up.

BACKGROUND:The pathogenesis of degenerative scoliosis is unclear,and asymmetric degeneration of the main curvature region may be strongly associated with the onset and progression of scoliosis.Fully recognizing the degeneration of the main curvature region can help to inform more clinical treatment strategies.OBJECTIVE:To explore the relationship between the degree of degeneration in the main curvature region and the parameters of the spinal pelvis in patients with degenerative scoliosis and to understand its pathogenesis.METHODS:The medical records and imaging data of patients with degenerative scoliosis admitted to Department of Spine Surgery,Affiliated Hospital of Southwest Medical University from July 2018 to November 2023 were collected.The difference in the facet joint osteoarthritis between concave and convex sides of the superior and inferior facet joints of the apical vertebra was compared to analyze the correlation between parameters such as the severity of scoliosis,spinopelvic parameters,and facet joint osteoarthritis and to explore the influencing effect between parameters such as the severity of scoliosis,spinopelvic parameters,and facet joint osteoarthritis.RESULTS AND CONCLUSION:(1)Among the facet joint of the apical vertebra,concave side was more severe than convex side with facet joint osteoarthritis,with a statistically significant difference(P＜0.001).On the same side(concave or convex side)of the apical vertebra superior facet joint osteoarthritis was more severe than inferior facet joint osteoarthritis,with a statistically significant difference(P＜0.001).(2)The pelvic incidence decreased with decreasing lumbar lordosis(rs=0.509,P＜0.001).The lateral osteophyte difference increased with decreasing lumbar lordosis(rs=-0.285,P=0.033).The facet joint tropism increased with decreasing pelvic incidence(rs=-0.379,P=0.004).(3)The L5 tilt angle and disc angle were risk factors for increased main curve Cobb angle(B=1.012,P＜0.001;8=0.620,P=0.016).Pelvic incidence was a protective factor against the increase of the main curve Cobb angle(B=-0.264,P=0.003).(4)It is concluded that in cases of degenerative scoliosis,the degree of degeneration on the concave side was significantly heavier than that on the convex side at the apical vertebra.There was no significant correlation between the severity of facet joint tropism and facet joint osteoarthritis and the severity of scoliosis.Lumbar lordosis and pelvic incidence played key roles in maintaining the normal spinal sequence.Pelvic incidence was a protective factor against the increase of the main curve Cobb angle.L5 tilt angle and disc angle were the risk factors for the increase of the main curve Cobb angle.

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.