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.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

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.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective Serum metabolomics combined with network pharmacology were used to explore the related metabolic pathways and action targets of Shuganheweitang(SGHWT)in the treatment of depression,and to explore the anti-depression mechanism of SGHWT.Methods Ten of the 40 SD male rats were randomly selected as normal control group,and the remaining 30 rats were reproduced as depressed rat model by chronic unpredictable mild stress(CUMS).They were divided into model group,SGHWT group(7.34 g·kg-1·d-1)and fluoxetine group(1.58 mg·kg-1·d-1),with 10 animals in each group and ontinuous modeling and gavage lasted for 6 weeks.The endogenous differential metabolites in rat serum were detected by UPLC-Q-TOF-MS/MS.The core components and key target information of SGHWT were selected by network pharmacology.Finally,combined analysis of differential metabolites and protein targets was carried out by Cytoscape software.Serum contents of arachidonic acid(AA),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and cyclooxygenase(COX-2)in each group were detected according to the analysis results.Results A total of 47 different metabolites were identified from the serum metabolome,18 of which could be recovered by SGHWT.Through pathway enrichment analysis,it was found that it was mainly involved in arachidonic acid metabolism and primary bile acid biosynthesis.71 active ingredients and 47 key target proteins of SGHWT were screened by network pharmacological means,and the proportion of arachidonic acid and related targets was the largest in the combined analysis.The ELISA results showed that compared with the control group,the serum contents of AA(P<0.05),IL-6(P<0.01)and TNF-α(P<0.01)in model group were significantly increased.Compared with model group,the contents of IL-6 and TNF-α in SGHWT group were significantly decreased(P<0.01).Conclusion The effective components of SGHWT have the characteristics of multi-target and multi-pathway in the treatment of depression.Further,the mechanism of action may be related to the fact that SGHWT is involved in regulating the metabolic pathway of arachidonic acid,inhibiting the level of inflammatory factors,and then improving the depression-like symptoms induced by chronic stress.

Objective Serum metabolomics combined with network pharmacology were used to explore the related metabolic pathways and action targets of Shuganheweitang(SGHWT)in the treatment of depression,and to explore the anti-depression mechanism of SGHWT.Methods Ten of the 40 SD male rats were randomly selected as normal control group,and the remaining 30 rats were reproduced as depressed rat model by chronic unpredictable mild stress(CUMS).They were divided into model group,SGHWT group(7.34 g·kg-1·d-1)and fluoxetine group(1.58 mg·kg-1·d-1),with 10 animals in each group and ontinuous modeling and gavage lasted for 6 weeks.The endogenous differential metabolites in rat serum were detected by UPLC-Q-TOF-MS/MS.The core components and key target information of SGHWT were selected by network pharmacology.Finally,combined analysis of differential metabolites and protein targets was carried out by Cytoscape software.Serum contents of arachidonic acid(AA),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and cyclooxygenase(COX-2)in each group were detected according to the analysis results.Results A total of 47 different metabolites were identified from the serum metabolome,18 of which could be recovered by SGHWT.Through pathway enrichment analysis,it was found that it was mainly involved in arachidonic acid metabolism and primary bile acid biosynthesis.71 active ingredients and 47 key target proteins of SGHWT were screened by network pharmacological means,and the proportion of arachidonic acid and related targets was the largest in the combined analysis.The ELISA results showed that compared with the control group,the serum contents of AA(P<0.05),IL-6(P<0.01)and TNF-α(P<0.01)in model group were significantly increased.Compared with model group,the contents of IL-6 and TNF-α in SGHWT group were significantly decreased(P<0.01).Conclusion The effective components of SGHWT have the characteristics of multi-target and multi-pathway in the treatment of depression.Further,the mechanism of action may be related to the fact that SGHWT is involved in regulating the metabolic pathway of arachidonic acid,inhibiting the level of inflammatory factors,and then improving the depression-like symptoms induced by chronic stress.

With the widespread application of extracorporeal membrane oxygenation (ECMO) technology, ECMO centers have been established in most regions of China, and the demand for ECMO transport is also increasing. Critically ill patients with ECMO carry many catheters. ECMO devices and accessories are cumbersome and numerous, requiring a large amount of manpower to assist in the transfer. At present, most of ECMO transport equipment are vertical carts provided by equipment suppliers, which cannot accommodate all ancillary equipment and are difficult to be loaded into ambulances for transportation. Therefore, critically ill patients face many risks if they need to be transported inter-hospital. A specific vehicle for ECMO patients was designed by the medical staff of the department of critical care medicine of Zhujiang Hospital of Southern Medical University, which integrates the ECMO host, oxygenator, centrifugal pump, portable ventilator, coagulation instrument, injection pump, monitor, oxygen cylinder, and etc., to greatly facilitate the transportionation. This invention obtained the National Utility Model Patent of China (ZL 2019 2 1201261.4). The new ECMO transport vehicle can facilitate the interhospital transport of critically ill patients, reduce the occurrence of accidents, shorten the transport time and reduce the number of transport personnel, and has a good clinical application value.

Objective:To investigate the clinical efficacy of high-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation in patients with dysphagia after stroke.Methods:Seventy-two stroke patients with dysphagia who received treatment in The First Hospital of Jiaxing from February 2019 to February 2020 were included in this study. They were randomly assigned to receive either electrical stimulation (control group, n = 36) or high-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation (observation group, n = 36) for 2 weeks. Changes in serum brain-derived neurotrophic factor, neuron-specific enolase, and vascular endothelial growth factor levels after treatment relative to before treatment were observed in each group. Scores of the swallowing function assessment scale, neurological deficit, and quality of life were compared between the control and observation groups. Results:After treatment, serum levels of brain-derived neurotrophic factor and vascular endothelial growth factor in the observation group were (7.98 ± 1.14) μg/L, (168.78 ± 10.28) ng/L, respectively, which were significantly higher than those in the control group [(5.80 ± 1.10) μg/L, (110.34 ± 10.47) ng/L, t = 8.26, 23.90, both P < 0.01]. Serum neuron-specific enolase level was significantly lower in the observation group than in the control group [(7.57 ± 1.17) μg/L vs. (10.66 ± 1.30) μg/L, t = 10.60, P < 0.001). The scores of swallowing function assessment scale and neurological deficits in the observation group were (2.47 ± 1.16) points and (7.03 ± 1.14) points, respectively, which were significantly lower than those in the control group [(5.75 ± 1.10) points, (9.66 ± 1.20) points, t = 12.31, 9.53, both P < 0.001]. Total effective rate [97.22% (35/36) vs. 77.78% (28/36)] and the score of swallowing quality of life questionnaire [(160.40 ± 8.32) points vs. (146.74 ± 8.10) points] were significantly higher in the observation group than in the control group ( χ2 = 4.57, P = 0.03, t = 7.25, P < 0.001). Conclusion:High-frequency repetitive transcranial magnetic stimulation combined with electrical stimulation can greatly improve neurological function and swallowing function of stroke patients with dysphagia. The combined therapy is of certain clinical value and innovation.

Objectives:This study aimed to evaluate the effect of the strategies on COVID-19 outbreak control in Shenzhen, and to clarify the feasibility of these strategies in metropolitans that have high population density and strong mobility.Methods:The epidemic feature of COVID-19 was described by different phases and was used to observe the effectiveness of intervention. Hierarchical spot map was drawn to clarify the distribution and transmission risk of infection sources at different time points. The Susceptible-Exposed-Infectious-Asymptomatic-Recovered model was established to estimate case numbers without intervention and compare with the actual number of cases to determine the effect of intervention. The positive rate of the nucleic acid test was used to reflect the risk of human exposure. A survey on COVID-19 related knowledge, attitude and behaviors were used to estimate the abilities of personal protection and emergency response.Results:The epidemic of COVID-19 in Shenzhen experienced the rising, plateau and decline stage. The case number increased rapidly at the beginning, with short duration of peak period. Although the epidemic curve showed human-to-human transmission, the "trailing" was not obvious. From the spot map, during the intervention period, the source of infection was widely distributed. More cases and higher transmission risk were observed in areas with higher population density. After the effective intervention measures, both infection sources and the risk of transmission decreased. After compared with the estimated case numbers without intervention, actual number proved the COVID-19 control strategies were effective. The positive rate of nucleic acid test for high risk populations decreased and no new cases reported since February 16. Shenzhen citizens had high knowledge, attitude and behavior level, and high protection ability and emergency response.Conclusions:Although the response initiated by the health administration department played a key role at the early stage of the epidemic, it was not enough to contain the outbreak of COVID-19. The first-level emergency response initiated by provincial and municipal government was effective and ensured the start of work resumption after the Spring Festival. Metropolitans like Shenzhen can also achieve the goals of strategies and measures for containment and mitigation of COVID-19.

Objective To explore the impact of arterial injury on distal limb blood supply in lower limb trauma. Meth?ods Retrospective analysis of 93 patients with different levels of lower limb arterial injury admitted to our hospital from June 2014 to August 2017. There were 84 males and 9 females aged 43.54±9.90 years (ranging 25-65 years). Revascularization was performed through open reduction. Patients were divided into three groups according to their arterial injury locations. Proximal ves?sels were along the superficial femoral artery, from its beginning to the point where it was divided into the descending genicular ar?tery and direct periosteal branches. Intermediate vessels were from the dividing point on the superficial femoral artery to the popli?teal artery before it was divided into the medial inferior genicular artery. Distal vessels were from the dividing point on the poplite?al artery to the distal end of the peroneal artery. The duration from injury to revascularization in the three groups were 13.67±5.99 h, 11.15±4.43 h, and 11.92±5.48 h, respectively. There was no significant difference between groups (F=1.564, P=0.215). ISS in the three groups were 13.00±3.74, 12.77±3.81, and 11.50±3.99, respectively. There was no significant difference between groups (F=1.445, P=0.241). The following items were compared among the three groups, postoperative creatine kinase, arterial blood lac?tate and limb compartment cut. Results Creatine kinase of the intermediate vascular group was 8 743.15±6 968.48 u/L, proximal vascular group 1 467.67±1 810.27 u/L, distal vascular group 2 893.51±1 304.56 u/L. The data of intermediate vascular group were higher than those of proximal and distal vascular groups with significant difference among the groups (F=22.587,P=0.000). The lactate of the intermediate vascular group was 3.20 ± 1.51 mmol/L, proximal vascular group 1.63 ± 0.46 mmol/L, distal vascular group 1.85±0.69 mmol/L with significant difference among the groups (F=20.612,P=0.000). The compartment cut of the intermedi?ate vascular group was incised in 24, but not in 15. The proximal vascular group was not incised in 18, while 15 was incised and 21 not incised in distal vascular group. The rates of compartment cut were 61.5%, 0 and 41.7%, respectively with significant differ? ences (χ2=19.156, P=0.000). Conclusion In lower limb injuries, the intermediate vascular (from the superficial femoral artery after it is divided into the descending genicular artery and direct periosteal branches to the popliteal artery before it is divided into the medial inferior genicular artery) injury leads to the most severe distal limb ischemia.