Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective To explore the application value of serum Syndecan-1 and endocan-1 combined with rapid sequential organ failure(qSOFA)score in the diagnosis and prognosis of sepsis.Methods The severity of 118 patients with sepsis was divided into the general sepsis group(48 cases),the severe sepsis group(42 cases)and the septic shock group(28 cases).According to the prognosis,patients were divided into the death group(n=32)and the survival group(n=86).A total of 118 healthy volunteers were selected as the control group.Serum Syndecan-1 and endocan-1 levels were detected by enzyme-linked immunosorbent assay(ELISA).The value of serum Syndecan-1,endocan-1 and qSOFA scores in the early diagnosis and prognosis of sepsis was analyzed by receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was compared.Results Compared with the control group,levels of Syndecan-1,endocan-1 and qSOFA scores were increased in the study group(P＜0.05).The serum Syndecan-1,endocan-1 and qSOFA score in the general sepsis group,the severe sepsis group and the septic shock group were significantly increased in sequence(P＜0.05).ROC curve analysis showed that the AUC of serum Syndecan-1,endocan-1 and qSOFA score in the diagnosis of sepsis(0.967)were higher than that of Syndecan-1(AUC=0.868),endocan-1(AUC=0.798)and qSOFA score(AUC=0.873)alone(Z=6.541,5.495 and 6.395,P＜0.001).Compared with the survival group,the levels of Syndecan-1,endocan-1 and qSOFA scores were significantly increased in the death group(P＜0.05).The combined prediction of AUC(0.983)was higher than that of Syndecan-1(AUC=0.814),endocan-1(AUC=0.834)and qSOFA score(AUC=0.924)alone(Z=6.596,9.268 and 6.904,P＜0.001).Conclusion Serum levels of Syndecan-1,endocan-1 and qSOFA are increased in patients with sepsis,and the combination of the three has higher clinical value in the diagnosis and prognosis evaluation of sepsis.

Objective To explore the application value of serum Syndecan-1 and endocan-1 combined with rapid sequential organ failure(qSOFA)score in the diagnosis and prognosis of sepsis.Methods The severity of 118 patients with sepsis was divided into the general sepsis group(48 cases),the severe sepsis group(42 cases)and the septic shock group(28 cases).According to the prognosis,patients were divided into the death group(n=32)and the survival group(n=86).A total of 118 healthy volunteers were selected as the control group.Serum Syndecan-1 and endocan-1 levels were detected by enzyme-linked immunosorbent assay(ELISA).The value of serum Syndecan-1,endocan-1 and qSOFA scores in the early diagnosis and prognosis of sepsis was analyzed by receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was compared.Results Compared with the control group,levels of Syndecan-1,endocan-1 and qSOFA scores were increased in the study group(P＜0.05).The serum Syndecan-1,endocan-1 and qSOFA score in the general sepsis group,the severe sepsis group and the septic shock group were significantly increased in sequence(P＜0.05).ROC curve analysis showed that the AUC of serum Syndecan-1,endocan-1 and qSOFA score in the diagnosis of sepsis(0.967)were higher than that of Syndecan-1(AUC=0.868),endocan-1(AUC=0.798)and qSOFA score(AUC=0.873)alone(Z=6.541,5.495 and 6.395,P＜0.001).Compared with the survival group,the levels of Syndecan-1,endocan-1 and qSOFA scores were significantly increased in the death group(P＜0.05).The combined prediction of AUC(0.983)was higher than that of Syndecan-1(AUC=0.814),endocan-1(AUC=0.834)and qSOFA score(AUC=0.924)alone(Z=6.596,9.268 and 6.904,P＜0.001).Conclusion Serum levels of Syndecan-1,endocan-1 and qSOFA are increased in patients with sepsis,and the combination of the three has higher clinical value in the diagnosis and prognosis evaluation of sepsis.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

As a common clinical disease, fracture is often accompanied by pain, swelling, bleeding as well as other symptoms and has a high disability rate, even threatening life, seriously endangering patients' physical and psychological health and quality of life. Medical practitioners take many strategies for the treatment of fracture healing, including Traditional Chinese Medicine (TCM). In the early stage of fracture healing, the local fracture is often in a state of hypoxia, accompanied by the expression of hypoxia inducible factor-1α (HIF-1α), which is beneficial to wound healing. Through literature mining, we thought that hypoxia, HIF-1α and downstream factors affected the mechanism of fracture healing, as well as dominated this process. Therefore, we reviewed the local characteristics and related signaling pathways involved in the fracture healing process and summarized the intervention of TCM on these mechanisms, in order to inspirit the new strategy for fracture healing, as well as elaborate on the possible principles of TCM in treating fractures based on the HIF molecular mechanism.

ObjectiveTo improve the quality standard of Yuanhu Zhitong oral liquid in order to strengthen the quality control of this oral liquid. MethodThin layer chromatography（TLC） was used for the qualitative identification of Corydalis Rhizoma and Angelicae Dahuricae Radix in Yuanhu Zhitong oral liquid by taking tetrahydropalmatine， corydaline reference substances and Corydalis Rhizoma reference medicinal materials as reference， and cyclohexane-trichloromethane-methanol（5∶3∶0.5） as developing solvent， Corydalis Rhizoma was identified using GF254 glass thin layer plate under ultraviolet light（365 nm）. And taking petroleum ether（60-90 ℃） -ether-formic acid（10∶10∶1） as developing solvent， Angelicae Dahuricae Radix was identified using a silica gel G TLC plate under ultraviolet light（305 nm）. High performance liquid chromatography（HPLC） was performed on a Waters XSelect HSS T3 column（4.6 mm×250 mm， 5 μm） with acetonitrile（A）-0.1% glacial acetic acid solution（adjusted pH to 6.1 by triethylamine）（B） as the mobile phase for gradient elution（0-10 min， 20%-30%A； 10-25 min， 30%-40%A； 25-40 min， 40%-50%A； 40-60 min， 50%-60%A）， the detection wavelength was set at 280 nm， then the fingerprint of Yuanhu Zhitong oral liquid was established， and the contents of tetrahydropalmatine and corydaline were determined. ResultIn the thin layer chromatograms， the corresponding spots of Yuanhu Zhitong oral liquid， the reference substances and reference medicinal materials were clear， with good separation and strong specificity. A total of 12 common peaks were identified in 10 batches of Yuanhu Zhitong oral liquid samples， and the peaks of berberine hydrochloride， dehydrocorydaline， glaucine， tetrahydropalmatine and corydaline. The similarities between the 10 batches of samples and the control fingerprint were all >0.90. The results of determination showed that the concentrations of corydaline and tetrahydropalmatine had good linearity with paek area in the range of 0.038 6-0.193 0， 0.034 0-0.170 0 g·L^-1， respectively. The methodological investigation was qualified， and the contents of corydaline and tetrahydropalmatine in 10 batches of Yuanhu Zhitong oral liquid samples were 0.077 5-0.142 9、0.126 1-0.178 2 g·L^-1， respectively. ConclusionThe established TLC， fingerprint and determination are simple， specific and reproducible， which can be used to improve the quality control standard of Yuanhu Zhitong oral liquid.

OBJECTIVE： To study the improvement effects of fibrinolytic enzyme from Sipunculus nudus （SNFE） on hemorheology disorder and vascular endothelium injury in naked acute blood stasis model rats. METHODS： SD rats were randomly divided into control group， model group， aspirin group （100 mg/kg） and SNFE high-dose and low-dose groups （2 500， 5 000     U/kg）， with 10 rats in each group. They were given relevant medicine intragastrically once a day， for consecutive 7 d. One hour after the 6th day of administration， except for control group， other groups were given adrenaline hydrochloride 0.8 mg/kg subcutaneously， and then the acute blood stasis model was induced by ice-water bath. Blood was collected from abdominal aorta 2 h after the next day. Blood rheological parameters such as whole blood viscosity （high， medium and low shear rate）， plasma viscosity， hematocrit， erythrocyte aggregation index and erythrocyte deformability index were measured by automatic rheometer. The contents of NO and ET-1 in plasma and their ratio were determined by ELISA， and the damaged degree of vascular endothelium were observed by HE staining. RESULTS： Compared with control group， whole blood viscosity of high， medium and low-shear rate， plasma viscosity， erythrocyte aggregation index and ET-1 content were increased significantly in model group， while erythrocyte deformability index， NO content and NO/ET-1 ratio were decreased significantly， with statistical significance （P＜0.05 or P＜0.01）. Compared with model group， whole blood viscosity of high， medium and low-shear rate， plasma viscosity， hematocrit， erythrocyte aggregation index and ET-1 content were decreased significantly in SNFE high-dose groups. Erythrocyte deformability index， NO content and NO/ET-1 ratio were increased significantly， with statistical significance （P＜0.05 or P＜0.01）. In SNFE low-dose group， erythrocyte deformability index and NO/ET-1 ratio were increased significantly， while ET-1 content was decreased significantly， with statistical significance （P＜0.05 or P＜0.01）. Vascular endothelial staining showed that compared with control group， the structure of aorta layers in model group was loose and disordered， the endothelial defect was incomplete， the vacuoles increased， and the endothelial damage was obvious. The endothelium of rats in each administration group was damaged to varying degrees， but the degree of injury was lighter than in model group. CONCLUSIONS： SNFE can improve hemorheological abnormalities and vascular endothelial injury in rats with acute blood stasis.

Objective To study the clinical effect of endovascular treatment on complex TASC-D type aortoiliac occlusive disease (AIOD). Methods Clinical data of 27 patients (35 limbs) of the TASC-D type AIOD were collected in Department of Cardiovascular Surgery and were retrospectively analyzed. According to the Fontaine staging and the corresponding imaging examination before surgery, the therapy programme was worked out. Two limbs received thrombectomies, and 33 limbs received endovascular treatments including 5 limbs received percutaneous transluminal angioplasty (PTA), 24 limbs received percutaneous transluminal angioplasty stenting (PTAS), and 4 limbs underwent catheter-directed thrombolysis. Patients were followed up for 3 to 36 months regularly by telephone or outpatient after operation. The clinical symptoms, ankle brachial index (ABI), complications and cumulative primary patency rates were evaluated. Results The overall success rate of endovascular treatment was 90.9% (30/33). Two limbs treated with PTAS and one limb with catheter-directed thormbolysis showed a poor outcome. ABI increased from (0.40 ± 0.15) prehospital to (0.82±0.20) for 1 month. After therapy for one year, the primary patency rate was 93.3%(28/30). At 24 months, the primary patency rate was 83.3%(25/30), and limb salvage rate was 94.3%(33/35). One limb resulted in above ankle amputation 10 days after admission to hospital, and 1 limb underwent toe amputation in 2 months after operation. Conclusion Endovascular therapy is a safe and effective method for TASC-D AIOD, which shows satisfactory clinical outcomes with short-term to mid-term patency rates.

To investigate the chemical constituents of ethyl acetate from Cirsium setosum, fifteen flavonoids were obtained by column chromatography on silica gel, MCI, Sephadex LH-20, and preparative HPLC. Their structures were identified as 4',5,6-trihydroxy-7-methoxyflavone(1), 4',5-dihydroxy-7,8-dimethoxyflavone(2), sorbifolin-6-O-β-glucopyranoside(3), kaempferol-7-O-α-L-rhamnoside(4), kaempferol(5), quercetin-3-O-β-D-glucosyl-7-O-α-L-rhamnoside(6), myricetin(7), myricetin-3-O-β-D-glucoside(8), 5,7- dihydroxy -3',4'- dimethoxyflavone(9), 3',4',5- trihydroxy-3,7-dimethoxyflavone(10), 3',3,4',5-tetrahydroxy-7-methoxyflavone(11), 3'-hydroxy-4',5,7-trimethoxyflavone(12), 7-hydroxy-3',4',5-trimethoxyflavone(13), 4',5-dihydroxy-2',3',7,8-tetramethoxylflavone(14), and 5-hydroxy-2',3',7,8-tetramethoxylflavone(15) by spectroscopic data analysis. All compounds were isolated from this plant for the first time.Compounds(1-15) were evaluated for their hypoglycemic activities by PTP1B enzyme model. Among them, compounds 2, 12, and 14 showed significant PTP1B inhibitory activities with IC₅₀ values of 2.54, 1.85, 2.11 μmol•L⁻¹, respectively.