ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

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 This study aims to investigate the pathogenesis and identify potential therapeutic targets for adolescent idiopathic scoliosis(AIS)through the utilization of bioinformatics analysis on gene chip data obtained from mesenchymal stem cells.Methods The gene chip GSE110359 was acquired from the gene expression omnibus(GEO)database to procure the gene expression profiles of mesenchymal stem cells derived from AIS and non AIS patients.Weighted gene co-expression network analysis(WGCNA)method was employed to identify the principal modules associated with adolescent idiopathic scoliosis.Furthermore,gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses were conducted.Additionally,immune cell infiltration analysis and protein-protein interaction(PPI)analysis were performed on 28 distinct immune cell types,leading to the identification of core genes.Results A total of eight gene co-expression modules were successfully identified.GO analysis revealed significant enrichment in various biological processes,including response to decreased oxygen levels,response to oxygen levels,ribonucleoprotein complex subunit organization,collagen-containing extracellular matrix,spliceosome snRNP complex,snRNA binding,and extracellular matrix structural components.KEGG analysis demonstrated enrichment in several pathways,such as hypoxia-inducible factor-1 signaling pathway,spliceosome,ferroptosis,fatty acid degradation,and other pathways.Furthermore,the findings pertaining to immune infiltration revealed a noteworthy decrease in the quantity of monocytes within the AIS group compared to the non AIS group(P<0.05).There was a heightened level of infiltration by activated dendritic cells in the AIS group(P<0.05).PPI analysis was conducted,resulting in the identification of angiopoietin-like 4(ANGPTL4),C-X-C motif chemokine ligand 8(CXCL8),solute carrier family 2 member 1(SLC2A1),hexokinase 2(HK2),and transferrin receptor protein(TFRC).Conclusion ANGPTL4,CXCL8,SLC2A1,HK2 and TFRC have been identified as potential biomarkers and therapeutic targets of AIS patients.Monocytes and activated dendritic cells have emerged as significant targets for immunotherapy in the context of AIS.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective:To screen lipid biomarker in sepsis patients with different survival outcome based on ultra high performance liquid chromatography-mass spectrometry(UHPLC-MS/MS) technique.Methods:From September 2019 to April 2020, 30 septic patients admitted in Department of Intensive Care Unit and 30 cases of physical examination at the same time in Shanxi Bethune Hospital were studied. Lipid metabolite in serum were detected by UHPLC-MS/MS technique. According to the 28 day survival outcome of sepsis patients, they were divided into survival group (21 cases) and death group (9 cases). The baseline data of case group and control group, survival group and death group were compared respectively. Independent sample t-test and orthogonal partial least squares discriminant analysis (OPLS-DA) were further performed to identify lipid biomarkers related to sepsis survival outcome. Receiver operating characteristic (ROC) curve to evaluate the predictive efficacy of differential lipids on the survival outcome of biomarker sepsis patients. Results:There were 32 lipid subclasses and 1 437 differential lipid molecules in the sepsis group compared with the control group. 196 differential lipid molecules in the sepsis survival group and the death group were screened according to the OPLS-DA model (variable weight of projection (VIP)>1), which were glycerophosphingolipids (129), sphingolipids (52), glycerides (14), and sterols (1).All the original data were statistically analyzed by univariate independent sample t-test. There were statistically significant differences in 15 lipid molecules between the two groups. Combined with VIP > 1 and P < 0.01, three lipid molecules were finally screened, which were sphingomyelin (SM) lipid molecules, SM (d30∶1), SM (d32∶2), SM (d32∶1). ROC curve analysis showed that the areas under curves of the above three lipid molecular were 0.915, 0.892, 0.898, respectively. The sensitivity was 77.27%, 95.45%,72.73%. The specificity was 100.0%, 87.5%,100.0%. Further Z-test showed that there was no significant difference in the area under the ROC curve ( Z(SM (d30∶1) and SM (d32∶1)) =0.36, P=0.722; Z(SM (d30∶1) and SM (d32∶2))=0.34, P=0.732; Z(SM (d32∶1) and SM (d32∶1))=0.07, P=0.942). Conclusions:Sphingomyelin may be involved in the formation of different clinical outcomes of sepsis, and has a good predictive effect on the survival outcome of sepsis.

Objective:To investigate the protective effect and mechanism of hyperbaric oxygen (HBO) on cardiac function in model rats with myocarditis.Methods:A total of 30 specific pathogen free (SPF) male SD rats aged 4~5 weeks were randomly divided into three groups with 10 rats in each group, which were the control group, the model group, and the HBO group. The control group was only given 1 ml/kg normal saline by tail vein injection without any other treatment; the rat models of myocarditis in the model group and the HBO group were established by injecting lipopolysaccharide (LPS) via tail vein; the HBO group was additionally treated with HBO. After 6 days of treatment, echocardiography was obtained by ultrasound imaging system for small animals; and the data of left ventricular ejection fraction (EF), fraction shortening (FS), and maximum ascending and descending rate (+ dP/dt max) were collected. The levels of serum interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), brain natriuretic peptide (BNP), and catalase (CAT) were detected by enzyme-linked immunosorbent assay (ELISA) kit. After euthanasia, the myocardial tissue was taken. Some of them was stained by Hematoxylin and Eosin (HE) for morphological observation; the rest was ground for detecting the expression levels of oxidative stress related factors, including superoxide dismutase (SOD) and malondialdehyde (MDA), by ELISA. Results:The results of echocardiography showed that EF, FS, + dP/dt max, and - dP/dt max in the model group were significantly lower than those in the control group ( P<0.05); after HBO treatment, EF, FS, + dP/dt max, and -dP/dt max in the HBO group were significantly higher than those in the model group ( P<0.05). The results of ELISA showed that IL-6, IL-1 β, TNF-α, and BNP in the model group were significantly higher than those in the control group ( P<0.05); after HBO treatment, IL-6, IL-1β, TNF-α, and BNP in the HBO group were significantly lower than those in the model group ( P<0.05). Under light microscope, there was no focal infiltration of inflammatory cells in the myocardial tissue of the control group. The cardiomyocytes of the model group were arranged disorderly with more inflammatory cell infiltration. And some pink protein mucus could be seen in some blood vessels. In the HBO group, inflammatory cell infiltration was milder than that in the model group. And there were some edematous cardiomyocytes. Compared with the control group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the model group were significantly decreased, while the expression level of MDA in myocardial tissue was significantly increased ( P<0.05). After HBO treatment, compared with the model group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the HBO group were significantly increased, while the expression of MDA in myocardial tissue was significantly decreased ( P<0.05). Conclusion:HBO treatment can improve the cardiac function in model rats with myocarditis by inhibiting the inflammatory response and alleviating oxidative stress damage.

Objective:To investigate the effects of early rehabilitation combined with hyperbaric oxygen (HBO) on neurological function recovery and prognosis of patients with hypertensive intracerebral hemorrhage (HICH) after emergency minimally invasive surgery.Methods:The clinical data of 121 HICH patients admitted to the departments of neurology and neurosurgery of Yantai Mountain Hospital and Laiyang Central Hospital from June 2016 to January 2020 were retrospectively analyzed and divided into observation group ( n=64) and control group ( n=57), according to their treatment. The patients in the control group were given early conventional rehabilitation treatment and electrostimulation after removal of intracranial hematoma by emergency minimally invasive intervention, while the patients in the observation group were given HBO treatment on the basis of the treatment in the control group. Six months after operation, the Chinese Medical Association neurological deficit score was used to evaluate the clinical efficacy. The National Institutes of Health stroke scale (NIHSS) and mini & mental state examination (MMSE) were used to evaluate the psychological improvement of the two groups. The Montreal cognitive assessment (MoCA) was used to evaluate the cognitive function of the two groups. The activities of daily living (ADL) scale was used to evaluate the activities of daily living of the two groups. The short form (SF-36) was used to evaluate the quality of life of the two groups six months after operation. Results:Six months after operation, the total effective rate of the observation group (87.5%) was higher than that of the control group (75.4%), with statistically significant difference ( P<0.05). Six months after operation, the NHISS and MMSE scores in the observation group were significantly different from those in the control group ( P<0.05). Compared with those before treatment, the MoCA and ADL scores of both groups were significantly increased six months after operation ( P<0.05); and these scores in the observation group were significantly higher than those in the control group ( P<0.05). The general health, vitality, physical functioning, role physical, mental health, role emotional, social functioning, and bodily pain scores of the observation group were significantly higher than those of the control group ( P<0.05). Conclusion:Early rehabilitation combined with HBO treatment after emergency minimally invasive surgery can promote the recovery of nerve cell function in patients with HICH, restore their life skills, enhance their motor function, thus improving their activities of daily living.

Objective:To investigate the protective effect and mechanism of hyperbaric oxygen (HBO) on cardiac function in model rats with myocarditis.Methods:A total of 30 specific pathogen free (SPF) male SD rats aged 4~5 weeks were randomly divided into three groups with 10 rats in each group, which were the control group, the model group, and the HBO group. The control group was only given 1 ml/kg normal saline by tail vein injection without any other treatment; the rat models of myocarditis in the model group and the HBO group were established by injecting lipopolysaccharide (LPS) via tail vein; the HBO group was additionally treated with HBO. After 6 days of treatment, echocardiography was obtained by ultrasound imaging system for small animals; and the data of left ventricular ejection fraction (EF), fraction shortening (FS), and maximum ascending and descending rate (+ dP/dt max) were collected. The levels of serum interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), brain natriuretic peptide (BNP), and catalase (CAT) were detected by enzyme-linked immunosorbent assay (ELISA) kit. After euthanasia, the myocardial tissue was taken. Some of them was stained by Hematoxylin and Eosin (HE) for morphological observation; the rest was ground for detecting the expression levels of oxidative stress related factors, including superoxide dismutase (SOD) and malondialdehyde (MDA), by ELISA. Results:The results of echocardiography showed that EF, FS, + dP/dt max, and - dP/dt max in the model group were significantly lower than those in the control group ( P<0.05); after HBO treatment, EF, FS, + dP/dt max, and -dP/dt max in the HBO group were significantly higher than those in the model group ( P<0.05). The results of ELISA showed that IL-6, IL-1 β, TNF-α, and BNP in the model group were significantly higher than those in the control group ( P<0.05); after HBO treatment, IL-6, IL-1β, TNF-α, and BNP in the HBO group were significantly lower than those in the model group ( P<0.05). Under light microscope, there was no focal infiltration of inflammatory cells in the myocardial tissue of the control group. The cardiomyocytes of the model group were arranged disorderly with more inflammatory cell infiltration. And some pink protein mucus could be seen in some blood vessels. In the HBO group, inflammatory cell infiltration was milder than that in the model group. And there were some edematous cardiomyocytes. Compared with the control group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the model group were significantly decreased, while the expression level of MDA in myocardial tissue was significantly increased ( P<0.05). After HBO treatment, compared with the model group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the HBO group were significantly increased, while the expression of MDA in myocardial tissue was significantly decreased ( P<0.05). Conclusion:HBO treatment can improve the cardiac function in model rats with myocarditis by inhibiting the inflammatory response and alleviating oxidative stress damage.

Objective:To investigate the effects of early rehabilitation combined with hyperbaric oxygen (HBO) on neurological function recovery and prognosis of patients with hypertensive intracerebral hemorrhage (HICH) after emergency minimally invasive surgery.Methods:The clinical data of 121 HICH patients admitted to the departments of neurology and neurosurgery of Yantai Mountain Hospital and Laiyang Central Hospital from June 2016 to January 2020 were retrospectively analyzed and divided into observation group ( n=64) and control group ( n=57), according to their treatment. The patients in the control group were given early conventional rehabilitation treatment and electrostimulation after removal of intracranial hematoma by emergency minimally invasive intervention, while the patients in the observation group were given HBO treatment on the basis of the treatment in the control group. Six months after operation, the Chinese Medical Association neurological deficit score was used to evaluate the clinical efficacy. The National Institutes of Health stroke scale (NIHSS) and mini & mental state examination (MMSE) were used to evaluate the psychological improvement of the two groups. The Montreal cognitive assessment (MoCA) was used to evaluate the cognitive function of the two groups. The activities of daily living (ADL) scale was used to evaluate the activities of daily living of the two groups. The short form (SF-36) was used to evaluate the quality of life of the two groups six months after operation. Results:Six months after operation, the total effective rate of the observation group (87.5%) was higher than that of the control group (75.4%), with statistically significant difference ( P<0.05). Six months after operation, the NHISS and MMSE scores in the observation group were significantly different from those in the control group ( P<0.05). Compared with those before treatment, the MoCA and ADL scores of both groups were significantly increased six months after operation ( P<0.05); and these scores in the observation group were significantly higher than those in the control group ( P<0.05). The general health, vitality, physical functioning, role physical, mental health, role emotional, social functioning, and bodily pain scores of the observation group were significantly higher than those of the control group ( P<0.05). Conclusion:Early rehabilitation combined with HBO treatment after emergency minimally invasive surgery can promote the recovery of nerve cell function in patients with HICH, restore their life skills, enhance their motor function, thus improving their activities of daily living.