Objective To explore the feasibility and safety of ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer.Methods Totally 84 patients who underwent ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer were enrolled,and the technical success rate,complete ablation rate,complication rate,pain relief rate and survival time,etc.were observed.Results The median age of 84 cases was 61.5 years.Totally 86 tumors,including 44.19％(38/86)at the head/neck and 55.81％(48/86)at the body/tail of pancreas were detected,and a total of 85 ablation sessions were performed with the median ablation energy applied per tumor of 9.90(1.08,21.60)kJ and the complete ablation rate of 42.86％(36/84).The technical success rate was 100％(85/85).Thirty-nine complication events occurred in 25 cases,no ablation-related death.Among 34 patients underwent ablation mainly for pain symptoms,the pain score decreased from(6.22±1.12)points before treatment to(1.94±1.64)points after treatment(P＜0.001).During 6.8(3.3,12.9)months' follow-up,the mean survival time was(8.5±6.7)months,and all 47 patients died due to tumor progression.Conclusion Ultrasound-guided percutaneous microwave ablation was safe and feasible for unresectable pancreatic cancer.

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 feasibility and safety of ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer.Methods Totally 84 patients who underwent ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer were enrolled,and the technical success rate,complete ablation rate,complication rate,pain relief rate and survival time,etc.were observed.Results The median age of 84 cases was 61.5 years.Totally 86 tumors,including 44.19％(38/86)at the head/neck and 55.81％(48/86)at the body/tail of pancreas were detected,and a total of 85 ablation sessions were performed with the median ablation energy applied per tumor of 9.90(1.08,21.60)kJ and the complete ablation rate of 42.86％(36/84).The technical success rate was 100％(85/85).Thirty-nine complication events occurred in 25 cases,no ablation-related death.Among 34 patients underwent ablation mainly for pain symptoms,the pain score decreased from(6.22±1.12)points before treatment to(1.94±1.64)points after treatment(P＜0.001).During 6.8(3.3,12.9)months' follow-up,the mean survival time was(8.5±6.7)months,and all 47 patients died due to tumor progression.Conclusion Ultrasound-guided percutaneous microwave ablation was safe and feasible for unresectable pancreatic cancer.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Objective To compare the hepatic lipid droplet metabolism in normal BKS-db/m mice and BKS-db/db mice,a model of type 2 diabetes mellitus (T2DM),and to investigate the characteristics of hepatic lipid droplet metabolism and the molecular mechanisms underlying the imbalance of metabolic homeostasis at the level of lipid droplet synthesis and lipid droplet catabolism in db/db mice. Methods Eight SPF 8 weeks BKS-db/m and 8 BKS-db/db mice were used in this study. The lipid metabolism level was tested. Oil red and HE staining was used to evaluate the degree of liver lipid deposition,and immunofluorescence staining and Western blot was used to observe the level of hepatic lipid droplet catabolism and metabolism. Results The body weight,liver weight,liver index,FPG,AUC of the OGTT,AUC of the ITT,TG,TC,HDL-C,LDL-C,FFA and SREBP1 positive fluorescence area and nuclear translocation were higher in db/db group than in db/m group (P<0.05). The lipophagia level of primary hepatocytes was higher in db/db group than in db/m group (P<0.05). Compared with the db/m group,the expressions of SREBP1,SCD1,PLIN2,LC3,LAMP2A and ATGL protein increased(P<0.05),while the expression of p-ACC/ACC protein decreased in the db/db group(P<0.05). Conclusions Compared with normal mice,T2DM mice had dyslipidemiaand marked hepatocellular lipid deposition.Although lipid droplet lipolysis and lipophagy were enhanced and catabolism was significant,the lipid droplet metabolism was in a state of imbalance between synthesis and catabolism,and the synthesis of lipid droplets was greater than that of catabolism,which led to the aggregation of hepatocellular lipids.

Objective To compare the hepatic lipid droplet metabolism in normal BKS-db/m mice and BKS-db/db mice,a model of type 2 diabetes mellitus (T2DM),and to investigate the characteristics of hepatic lipid droplet metabolism and the molecular mechanisms underlying the imbalance of metabolic homeostasis at the level of lipid droplet synthesis and lipid droplet catabolism in db/db mice. Methods Eight SPF 8 weeks BKS-db/m and 8 BKS-db/db mice were used in this study. The lipid metabolism level was tested. Oil red and HE staining was used to evaluate the degree of liver lipid deposition,and immunofluorescence staining and Western blot was used to observe the level of hepatic lipid droplet catabolism and metabolism. Results The body weight,liver weight,liver index,FPG,AUC of the OGTT,AUC of the ITT,TG,TC,HDL-C,LDL-C,FFA and SREBP1 positive fluorescence area and nuclear translocation were higher in db/db group than in db/m group (P<0.05). The lipophagia level of primary hepatocytes was higher in db/db group than in db/m group (P<0.05). Compared with the db/m group,the expressions of SREBP1,SCD1,PLIN2,LC3,LAMP2A and ATGL protein increased(P<0.05),while the expression of p-ACC/ACC protein decreased in the db/db group(P<0.05). Conclusions Compared with normal mice,T2DM mice had dyslipidemiaand marked hepatocellular lipid deposition.Although lipid droplet lipolysis and lipophagy were enhanced and catabolism was significant,the lipid droplet metabolism was in a state of imbalance between synthesis and catabolism,and the synthesis of lipid droplets was greater than that of catabolism,which led to the aggregation of hepatocellular lipids.

The paper reported a case of a young male patient, with graft-versus-host disease (GVHD) multi-organ involvement lesions after allo-hematopoietic stem cell transplantation. The patient had diverse clinical manifestations, and overlapping acute and chronic disease processes. Acute GVHD were mainly hyperbilirubinemia, with or without elevated transaminase, bloody watery stools; chronic GVHD were highlighted by extensive skin depigmentation, oral mucosal ulcer, sick nails, etc., and chronic signs, such as membranous nephropathy, polyserositis and pulmonary restrictive ventilatory insufficiency. The diagnosis of chronic GVHD mainly relies on medical history combined with clinical manifestations, and it's needed to exclude infections, drugs and tumors. Besides, the rate of missed diagnosis and misdiagnose is high, and it requires multidisciplinary diagnosis and treatment. Combined with the literature review, it indicates that there is a greater risk of GVHD in the male recipient with female donor, and peripheral blood stem cell transplant patients have a higher incidence than bone marrow transplant patients after hematopoietic stem cell transplantation, but the effect of the graft-versus-leukemia exists. Currently, glucocorticoids therapy with or without calcineurin inhibitors are the first-line treatment for GVHD, but the overall prognosis is poor.

Objective:To investigate the relationships between hyperuricemia and the incidence risk for cardiometabolic abnormity in children.Methods:Data were obtained from School-based Cardiovascular and Bone Health Promotion Program. In 2017, a total of 15 391 children aged 6-16 years in Beijing were selected through stratified cluster sampling at baseline survey. Follow-up investigation was conducted in 2019. Logistic regression model was used to analyze the relationships of uric acid quartiles and change in uric acid levels with incidence risks for cardiometabolic abnormity (hypertension, hyperglycemia and dyslipidemia).Results:A total of 8 807 children (4 376 boys, 4 431 girls) were included in the analysis, the average age of the children was (11.1±3.3) years at baseline survey. The adjusted odds ratios ( ORs) and 95% confidence intervals ( CIs) of incidence risk for hypertension in the third and fourth quartiles of the UA were 1.39 (1.11-1.75) and 1.56 (1.19-1.81), respectively. The ORs and 95% CIs of risk for high LDL-C in the second, third and fourth quartiles were 1.88 (1.16-3.05),1.98 (1.23-3.17) and 2.25 (1.42-3.57). The uric acid level increased by one standard deviation, the risk increased by 17% for hypertension and 27% for high LDL-C. The uric acid level increased by 10 μmol/L, the risk increased by 2.1% for hypertension and 2.9% for high LDL-C. The gender-stratified analysis showed that the similar results. The ORs and 95% CIs were 1.32 (1.09-1.60) and 1.50 (1.05-2.16) for hypertension, 1.90 (1.38-2.60) and 2.96 (1.58-5.52) for high TC, 1.78 (1.26-2.51) and 2.84 (1.60-5.03) for high LDL-C in the groups of newly diagnosed hyperuricemia and persistent hyperuricemia. Conclusions:Higher uric acid level was associated with increased incidence risks for hypertension, abnormal TC and LDL-C. Maintaining optimal uric acid level by children might contribute to the early prevention of cardiovascular diseases.

Objective:To explore the correlation between serum 25-hydroxyvitamin D3 [25(OH)D3] level and peritoneal dialysis (PD) associated peritonitis, and provide a new idea for the prevention and treatment of peritonitis.Methods:In this single-center retrospective cohort study, patients who were≥18 years old and were treated with regular PD≥3 months in PD center from January 1, 2014 to September 30, 2018 were recruited, except those who had a history of malignant tumors or systemic infectious diseases, transferred from permanent hemodialysis (HD) or failed kidney transplantation. Baseline data including demographic characteristics as well as clinical and biochemical data were collected. All the patients were followed up until death, transfer to HD, kidney transplantation, transfer to other centers or the end of our study (December 31, 2018), and were divided into low tertile [serum 25(OH)D3 ≤12μg/L], middle tertile[12 μg/L17 μg/L] according to the baseline serum 25(OH)D3 level. Multivariate adjusted Poisson model was used to evaluate the association between serum 25(OH)D3 level and PD related peritonitis.Results:A total of 642 patients were enrolled in our study, of whom 341 were male (53.12%) , and the age was (47.58±14.10) years old. The serum 25(OH)D3 level was (13.83±6.41) μg/L. As for the primary disease, 67.19% were chronic glomerulonephritis. During a median 42(19, 59) months follow-up period, 232 peritonitis occurred in 139 patients. After adjusting for confounders, including gender, age, albumin, body mass index(BMI), calcium-phosphorus product, intact parathyroid hormone (iPTH), diabetes, charlson index and drug use, multivariate Poisson regression analysis showed that the risk of peritonitis in the middle tertile and the low tertile was 92% (95% CI 0.62-1.38, P= 0.690) and 1.74 times (95% CI 1.19-2.54, P=0.004) of the high tertile respectively. The difference between the low tertile and the high tertile was statistically significant. Conclusions:The level of serum 25(OH)D3 is closely related to the occurrence of PD associated peritonitis. Low level serum 25(OH)D3 is an independent risk factor for peritonitis in PD patients.