BACKGROUND:Patients with osteoporotic compression fractures of the lumbar spine have varying degrees of changes in the sagittal parameters of the spine and pelvis,resulting in disequilibrium and rebalancing of the sagittal plane of the whole spine/lumbar spine.If the primary osteoporotic vertebral compression fracture is not treated promptly,it develops into an old osteoporotic vertebral compression fracture with nonunion over time. OBJECTIVE:To observe the effect of percutaneous vertebroplasty in nine patients with old osteoporotic lumbar compression fracture with nonunion. METHODS:A retrospective analysis was conducted on the clinical data of nine elderly patients with old osteoporotic lumbar compression fractures with nonunion treated in the Orthopedics Department of Shanghai Public Health Clinical Center from September 2018 to August 2022.All patients underwent revision treatment with percutaneous vertebroplasty and received regular anti-osteoporosis treatment and rehabilitation training.The lumbar spine X-ray plain film and three-dimensional CT test results were reviewed before discharge and during follow-up to evaluate the diffusion of bone cement.Visual analog scale score,lumbar Oswestry disability index score,and Roussouly classification were recorded before,after surgery and during follow-up. RESULTS AND CONCLUSION:(1)During postoperative follow-up,none of the 9 cases in this group experienced serious surgical complications such as nerve injury,infection,bone cement leakage,pulmonary embolism,and allergic shock,and no adverse reactions related to bone cement occurred.One patient died of respiratory failure due to COVID-19 infection 2 years after operation.(2)The visual analog scale score and Oswestry disability index score of postoperative pain in patients with recurrent vertebral fractures after percutaneous vertebroplasty were significantly lower than those before revision surgery.After the last follow-up percutaneous vertebroplasty revision surgery,the Roussouly classification of patients significantly improved.There was no statistically significant difference between the changes in vertebral body height during the last follow-up measurement and preoperative comparison.(3)These findings indicate that for patients with old osteoporotic lumbar compression fractures with nonunion,moderate injection of bone cement and effective dispersion of bone cement have a significant relieving effect on postoperative pain.Regular anti-osteoporosis and effective postoperative rehabilitation training can help patients improve their postoperative lumbar spine function.

Pharmaceutical cocrystals is an advanced technology to improve the physicochemical and biological properties of drugs. However, there are few studies on the in vivo metabolism of pharmaceutical cocrystals. In this study, the pharmacokinetics of wogonin cocrystal in normal rats was further studied on the basis of the previous preparation of wogonin-aloperine cocrystal. Firstly, an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was established for simultaneous determination of wogonin and its metabolite wogonoside in rat plasma, and to investigate the methodology. The method was applied to the pharmacokinetic study of wogonin-aloperine cocrystal (Wog-Alop) in rats. The results showed that wogonin and its metabolite wogonoside had a good linear relationship in the range of 1-800 ng·mL^-1, and the precision, accuracy, matrix effect and stability in this range met the requirements of biological analysis. Compared with direct administration of wogonin, the C_max of wogonin and its metabolite in rats increased to 7.44-fold and 9.15-fold, AUC_0-t increased to 1.67-fold and 3.72-fold, and oral bioavailability of wogonin increased to 187.66% after cocrystal administration. Wog-Alop cocrystal can significantly improve the C_max, AUC, and oral bioavailability of wogonin and its metabolite, which provides a new perspective for the clinical application of wogonin. This study was approved by the Experimental Animal Ethics Review Committee of Beijing University of Chinese Medicine (approval number: BUCM-2023032307-1148).

Objective:Exploratory study on the relationship between TCM syndrome types, TCM constitution and clinical symptoms of idiopathic central precocious puberty children and rapidly progressive early development children in Shanghai, so as to provide a basis for early intervention and syndrome differentiation and treatment.Methods:A cross-sectional study and retrospectively enrolled. Through questionnaire survey, the basic information, clinical symptoms and TCM constitution of children diagnosed with idiopathic central precocious puberty and rapidly progressive early development were collected from the Pediatric Endocrinology Clinic of Affiliated Shuguang Hospital of Shanghai University of Traditional Chinese Medicine from July to August 2022, and the correlation between the distribution, differentiation and clinical symptoms of TCM constitution in children with idiopathic central precocious puberty and children with rapidly progressive precocious puberty in Shanghai were explored through data analysis.Results:① Fast progressive early development children with higher BMI and age than idiopathic central precocious puberty were statistically significant ( P<0.05), and no significant difference in the sex composition ratio between the two groups. ② Among children with idiopathic central precocious puberty and children with rapid progressive early development, the proportion of liver depression fire syndrome was the highest, 59.15% (42/71) and 46.51% (60/129) respectively, and the proportion of Qi depression was the highest, 35.21% (25/71) and 36.43% (47/129) respectively. However, there was no significant difference in the TCM syndrome types and physical distribution of the two groups. ③ The TCM syndrome types of 200 precocious children weres correlated with physical distribution, among which Yin deficiency fire flourishing syndrome was significantly associated with Yin deficiency, liver stagnation fire syndrome was significantly correlated with qi depression, and phlegm dampness obstruction syndrome was significantly correlated with phlegm dampness and Yang deficiency ( P<0.01). ④ A total of 200 children with precocious puberty were more female than male, male BMI was higher than female, and the BMI of children with precocious puberty was higher than other syndrome types, and the differences were statistically significant ( P<0.01). Liver stasis fire syndrome was the highest proportion between boys and girls, but there was no obvious difference in TCM syndrome types between different genders. The highest proportion of breast pain in clinical symptoms was 22.19% (69/311). Conclusion:Children with idiopathic central precocious puberty and rapidly progressive early development children have differences in age and BMI, with no obvious difference in gender composition, TCM syndrome type and physical distribution, but there is a correlation between TCM syndrome type and physical constitution of precocious puberty children.

Objective To observe the therapeutic effects and mechanisms of Guanyuan Mingmen Sequential Acupuncture on rats with premature ovarian insufficiency(POI)model.Methods Female SD rats were divided into the blank group,the model group,the protein kinase A(PKA)inhibitor(H89)+acupuncture group,and the acupuncture group,with 12 rats in each group.Except for the blank group,the POI model was prepared by gavage with Tripterygium Glycosides Tablets in the other three groups of rats.After the model was successfully established,the blank group and the model group were bundled once a day;in the acupuncture group,Guanyuan(RN4)point was taken during the intermotility period,and in the pre-motility period,Mingmen(DU4)point was taken;in the H89+acupuncture group,the intervention was performed in accordance with the acupuncture protocol of the acupuncture group,and H89 was injected intraperitoneally for 30 minutes prior to each acupuncture session.Continuous intervention was performed for 20 days.Samples were taken from each group of rats in the first estrus period and in proestrus period after intervention.Enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of follicle stimulating hormone(FSH)and estradiol(E2)during the estrous phase,Western Blot was used to measure the protein expressions of follicle stimulating hormone receptor(FSHR)and aromatase P450(P450arom)during the estrous phase,and the activity of granulocytes during the estrous phase and the proestrus phase were measured using the cell-counting kit 8(CCK-8)method.The immunohistochemistry method was used to detect the protein expression of pre-motility proliferating cell nuclear antigen(PCNA).Results(1)Compared with the blank group,the serum FSH level of the model group and H89+acupuncture group was significantly increased(P＜0.01),and the E2 level was significantly decreased(P＜0.001);there was no difference between the FSH level of the H89+acupuncture group and that of the model group(P＞0.05),and the E2 level of the H89+acupuncture group was lower than that of the model group(P＜0.05);the FSH level of the acupuncture group was lower than that of the model group and that of the H89+acupuncture group(P＜0.05),had no difference with the blank group(P＞0.05),E2 level was significantly higher than the model group and H89+ acupuncture group(P＜0.01),still being lower than the blank group(P＜0.05).(2)The protein expressions of FSHR and P450arom in the model group and H89 + acupuncture group was lower than those in the blank group;the protein expression of FSHR in the H89 + acupuncture group was not different from that in the model group(P＞0.05),while the protein expression level of P450arom was lower than that in the model group(P＜0.05);the protein expression levels of FSHR and P450arom in the acupuncture group were higher than those in the model group and H89 + acupuncture group,but still lower than those in the blank group(P＜0.05).(3)Both GCs activity and average optical density value of PCNA in the model group and H89+acupuncture group were lower than the blank group(P＜0.05);both GCs activity and average optical density value of PCNA in the H89+acupuncture group were lower than the model group(P＜0.05);the activity of GCs and average optical density value of PCNA of the acupuncture group were significantly higher than that of the model group and H89+acupuncture group(P＜0.05 or P＜0.01).Conclusion Guanyuan Mingmen Sequential Acupuncture can regulate sex hormone levels,increase GCs activity and promote GCs cell proliferation by up-regulating protein expressions of follicle stimulating hormone receptor(FSHR)/cyclic adenosine monophosphate(cAMP)/protein kinase A(PKA)pathway FSHR,P450arom,thus improving POI.

ObjectiveBased on fluorescence lifetime imaging technology, a novel method for viscosity detection is proposed and the capability of different weighting of fluorescence lifetimes in distinguishing the viscosity of glycerol-water mixtures is evaluated, aiming to enhance the accuracy and reliability of viscosity differentiation. MethodsThis approach incorporates the principles of electronic weighting, introducing both amplitude-weighted average fluorescence lifetime (τ_m) and intensity-weighted average fluorescence lifetime (τ_i). Viscosity changes in glycerol-water mixtures are detected through τ_m and τ_i. τ_m Reflects the relationship between fluorescence signal amplitude and time, while τ_i focuses on the time-varying characteristics of fluorescence signal intensity. ResultsThe results of both τ_m and τ_i mutually corroborate each other, not only enhancing the reliability in detecting viscosity changes in glycerol-water mixtures but also revealing their unique roles in the detection process. Although τ_m plays a crucial role in capturing changes in fluorescence signal amplitude, τ_i exhibits higher accuracy in viscosity detection when considering the time-varying characteristics of fluorescence signal intensity. It is particularly noteworthy that, due to τ_i’s greater sensitivity, microenvironment viscosity detection can be directly analyzed using τ_i. This provides a more convenient approach for real-time, highly sensitive microfluidic viscosity monitoring. Therefore, through the comprehensive utilization of τ_m and τ_i, a more thorough and accurate understanding of the viscosity information in glycerol-water mixtures can be obtained, and specific parameters can be selected for in-depth analysis based on specific needs. ConclusionThe combination of amplitude weighting and intensity weighting allows for a more sensitive identification of subtle changes in viscosity under different conditions. The innovation of this method lies in its simultaneous consideration of multiple parameters, enhancing sensitivity and distinguishability to variations in viscosity. Therefore, this weighted-dependent fluorescence lifetime imaging technique not only introduces a novel approach for viscosity detection in glycerol-water mixtures but also provides a powerful analytical tool for various fields, including microfluidics, rheology, and research on novel functional materials.

Bacterial biofilms gave rise to persistent infections and multi-organ failure, thereby posing a serious threat to human health. Biofilms were formed by cross-linking of hydrophobic extracellular polymeric substances (EPS), such as proteins, polysaccharides, and eDNA, which were synthesized by bacteria themselves after adhesion and colonization on biological surfaces. They had the characteristics of dense structure, high adhesiveness and low drug permeability, and had been found in many human organs or tissues, such as the brain, heart, liver, spleen, lungs, kidneys, gastrointestinal tract, and skeleton. By releasing pro-inflammatory bacterial metabolites including endotoxins, exotoxins and interleukin, biofilms stimulated the body’s immune system to secrete inflammatory factors. These factors triggered local inflammation and chronic infections. Those were the key reason for the failure of traditional clinical drug therapy for infectious diseases.In order to cope with the increasingly severe drug-resistant infections, it was urgent to develop new therapeutic strategies for bacterial-biofilm eradication and anti-bacterial infections. Based on the nanoscale structure and biocompatible activity, nanobiomaterials had the advantages of specific targeting, intelligent delivery, high drug loading and low toxicity, which could realize efficient intervention and precise treatment of drug-resistant bacterial biofilms. This paper highlighted multiple strategies of biofilms eradication based on nanobiomaterials. For example, nanobiomaterials combined with EPS degrading enzymes could be used for targeted hydrolysis of bacterial biofilms, and effectively increased the drug enrichment within biofilms. By loading quorum sensing inhibitors, nanotechnology was also an effective strategy for eradicating bacterial biofilms and recovering the infectious symptoms. Nanobiomaterials could intervene the bacterial metabolism and break the bacterial survival homeostasis by blocking the uptake of nutrients. Moreover, energy-driven micro-nano robotics had shown excellent performance in active delivery and biofilm eradication. Micro-nano robots could penetrate physiological barriers by exogenous or endogenous driving modes such as by biological or chemical methods, ultrasound, and magnetic field, and deliver drugs to the infection sites accurately. Achieving this using conventional drugs was difficult. Overall, the paper described the biological properties and drug-resistant molecular mechanisms of bacterial biofilms, and highlighted therapeutic strategies from different perspectives by nanobiomaterials, such as dispersing bacterial mature biofilms, blocking quorum sensing, inhibiting bacterial metabolism, and energy driving penetration. In addition, we presented the key challenges still faced by nanobiomaterials in combating bacterial biofilm infections. Firstly, the dense structure of EPS caused biofilms spatial heterogeneity and metabolic heterogeneity, which created exacting requirements for the design, construction and preparation process of nanobiomaterials. Secondly, biofilm disruption carried the risk of spread and infection the pathogenic bacteria, which might lead to other infections. Finally, we emphasized the role of nanobiomaterials in the development trends and translational prospects in biofilm treatment.

Objective To establish a method for simultaneous determination of 11 components of Solanum nigrum from different producing areas,and to evaluate the quality by chemometrics and entropy weight-technique for order preference by similarity to ideal solution(EW-TOPSIS).Methods The 17 batches of Solanum nigrum samples from 8 provinces were collected.The high performance liquid chromatography(HPLC)method was used to simultaneously determine the contents of medioresino,pinoresinol,quercetin,rutoside,solasonine,solamargine,khasianine,solasodine,desgalactotigonin,diosgenin and β-sitosterol,and the multi-components quantitative control mode of Solanum nigrum was established.The quality evaluation model of Solanum nigrum was established by using chemical recognition pattern and EW-TOPSIS method,and the overall quality was evaluated comprehensively.Results When the 11 components were in the 0.78-39.00,0.55-27.50,0.34-17.00,0.21-10.50,41.87-2 093.50,60.95-3 047.50,2.58-129.00,1.02-51.00,0.46-23.00,1.05-52.50 and 0.42-21.00 μg/mL(r＞0.999 0),their linear relationships were good.The average recovery was 96.81％-100.28％with the RSD＜2.0％(n=9).17 batches of samples clustered into 3 categories.Solamargine,solasonine,desgalactotigonin and medioresino may be the main potential markers affecting the quality of Solanum nigrum.The results of EW-TOPSIS method showed that,the quality evaluation closeness of 17 batches of Solanum nigrum were 0.433 6,0.416 8,0.624 2,0.500 8,0.479 1,0.636 1,0.568 3,0.250 0,0.190 9,0.222 1,0.170 7,0.720 0,0.698 3,0.744 7,0.717 9,0.720 9 and 0.718 3,respectively,indicating that the overall quality of Solanum nigrum from Liaoning,Jilin and Heilongjiang were better,followed by Jiangsu,Henan and Anhui.Conclusion The established HPLC method for simultaneous determination of 11 components in Solanum nigrum is convenient and accurate.Chemometrics and EW-TOPSIS method are objective and comprehensive,which can be used for the overall quality evaluation of Solanum nigrum.

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 observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.