1.Matrix Stiffness-mediated Regulation of Vascular Regeneration During Tissue Repair
Kang-Bo WANG ; Wei-Ke LI ; Jing LONG ; Ying-Xiong WANG ; Ru-Fei GAO ; Zhen-Yin CHEN
Progress in Biochemistry and Biophysics 2026;53(9):2269-2282
Tissue repair requires the reconstruction of functional vascular networks to restore oxygen and nutrient delivery, eliminate metabolic waste, and maintain tissue homeostasis. Although biochemical factors such as growth factors and cytokines have been extensively studied in vascular regeneration, increasing evidence indicates that mechanical signals from the extracellular matrix (ECM) are equally important regulators of angiogenesis. Matrix stiffness, as a major biomechanical property of the tissue microenvironment, provides critical information that influences endothelial cell (EC) behavior and vascular remodeling through mechanotransduction. However, the biological effects of matrix stiffness are not universally defined as either pro- or anti-angiogenic, but are highly dependent on tissue context, cellular composition, disease progression, and the dynamic changes occurring during tissue repair. Therefore, understanding how matrix stiffness regulates vascular regeneration is essential for developing more precise strategies for tissue engineering and regenerative medicine. In this review, we summarize recent advances in the regulation of angiogenesis by matrix stiffness during tissue repair from multiple perspectives. First, we discuss the direct effects of matrix stiffness on EC behaviors, including differentiation, morphological remodeling, migration, proliferation, barrier maintenance, and vascular network formation. ECs sense mechanical alterations in the surrounding matrix through various mechanosensitive structures, including integrins, focal adhesion complexes, and mechanosensitive ion channels such as Piezo1 and TRPV proteins. These mechanical signals are subsequently transmitted through intracellular pathways involving FAK, RhoA/ROCK, MAPK, and Hippo-YAP/TAZ signaling, leading to cytoskeletal reorganization and transcriptional regulation. Through these mechanisms, matrix stiffness regulates endothelial functional states and determines the balance between regenerative vascular formation and pathological vascular remodeling. Beyond the direct regulation of ECs, we further highlight the importance of stiffness-mediated intercellular communication within the regenerative microenvironment. Matrix stiffness can regulate the behavior and secretory profiles of vascular-associated cells, including mesenchymal stem cells and macrophages, thereby indirectly affecting endothelial function through paracrine mechanisms. Changes in matrix mechanics influence the secretion of angiogenic factors, inflammatory cytokines, and extracellular vesicles from these cells, creating a mechanical regulation network that coordinates vascular regeneration. This perspective extends the traditional concept of matrix stiffness from a physical support structure to an active regulatory signal that integrates multiple cellular responses during tissue repair. Furthermore, we discuss the tissue-specific effects of matrix stiffness in vascular regeneration across different organs, including the aorta, lung, liver, and heart. Although excessive matrix stiffening is frequently associated with fibrosis and vascular dysfunction, the consequences of mechanical changes vary considerably among tissues. Moderate stiffness alterations may support endothelial activation and vascular stabilization in certain regenerative contexts, whereas persistent pathological stiffening can promote inflammation, endothelial dysfunction, and impaired vascular repair. These findings emphasize that the biological meaning of “soft” and “stiff” microenvironments should be interpreted according to specific tissue and experimental conditions rather than as universal mechanical classifications. Finally, we summarize current challenges and future perspectives in this field. A major limitation is the lack of standardized mechanical characterization among different studies, as stiffness measurements are influenced by material properties, testing methods, and experimental conditions, limiting direct comparison across research systems. Moreover, most existing models fail to fully reproduce the dynamic and viscoelastic properties of native ECM during tissue regeneration. Future studies should combine advanced biomaterials with standardized mechanical analysis, organoid models, and multi-omics approaches to establish more accurate mechanical regulatory maps. Overall, this review proposes that matrix stiffness is not merely a structural feature of tissues, but an active biological signal that regulates vascular regeneration through coordinated mechanotransduction and multicellular interactions. A deeper understanding of stiffness-mediated vascular regulation will provide new theoretical insights and therapeutic opportunities for improving tissue repair outcomes.
2.Exploration and application of pyrolysis in production of fuel gas from traditional Chinese medicine solid waste under "dual carbon" goals.
Ying-Lei LU ; Xu LONG ; Ke-Ying WANG ; Jing-Li LIU ; Yan-Lei ZHANG ; Yu-Ping TANG
China Journal of Chinese Materia Medica 2025;50(6):1437-1448
Traditional Chinese medicine(TCM) solid waste is characterized by widespread availability, renewability, and substantial production volume. In the context of the "dual carbon" goals, the pyrolysis of TCM solid waste for producing fuel gas for recycling in pharmaceutical production has emerged as a crucial strategy for optimizing the energy structure in the TCM industry and developing renewable energy. This paper comprehensively reviews both internal and external factors that influence the pyrolysis of TCM solid waste. Internal factors encompass moisture content, particle size, ash content, and the morphology of the raw materials, while external factors include pyrolysis conditions, equivalence ratios, types of gasifiers, and gasifying agents. Furthermore, this paper details the challenges associated with the pyrolysis of TCM solid waste, such as the dispersion of feedstocks, the diversity of resources, the complexity of the pyrolysis process, and the variations in gasifier performance. Finally, this paper proposes measures to address these challenges. This paper aims to provide insights into the development of a circular economy for TCM resources and the advancement of low-carbon energy utilization in the TCM industry.
Pyrolysis
;
Carbon/chemistry*
;
Medicine, Chinese Traditional
;
Solid Waste/analysis*
;
Drugs, Chinese Herbal/chemistry*
;
Gases/chemistry*
3.Expert consensus on intraoperative repositioning for patients with spine fracture and dislocation (version 2025)
Dongmei BIAN ; Ke SUN ; Ningbo CHEN ; Caixia BAI ; Miao WANG ; Yafeng QIAO ; Fei WANG ; Hong WANG ; Feng TIAN ; Mei YAN ; Meng BAI ; Linjuan ZHANG ; Liyan ZHAO ; Yaqing CUI ; Xue JIANG ; Leling FENG ; Ning NING ; Junqin DING ; Lan WEI ; Yonghua ZHAI ; Yu ZENG ; Zengmei ZHANG ; Jiqun HE ; Fenggui BIE ; Hong CHEN ; Zengyan WANG ; Li LI ; Li ZHANG ; Yaying ZHOU ; Bing SHAO ; Ying WANG ; Caixia XIE ; Yanfeng YAO ; Jingjing AN ; Wen SHI ; Xiongtao LIU ; Xiaoyan AN ; Ning NAN ; Lan LI ; Xiaohui GOU ; Qiaomei LI ; Xiuting WU ; Yuqin ZHANG ; Jing LIU ; Fusen XIANG ; Xu XU ; Na MEI ; Jiao ZHOU ; Shan FAN ; Qian WANG ; Shuixia LI
Chinese Journal of Trauma 2025;41(2):138-147
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.
4.Predictive value of serum NINJ1,CysC and D-D for unfavorable outcomes in patients with acute myo-cardial infarction
Ke CHEN ; Jing-ying WANG ; Min XU ; Hong-yan YANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2025;34(4):521-526
Objective:To investigate the predictive value of serum levels of Ninjurin 1(NINJ1),cystatin C(CysC),and D-dimer(D-D)for unfavorable outcomes in patients with acute myocardial infarction(AMI).Methods:A total of 118 AMI patients hospitalized in the Chinese PLA Joint Logistic Support Force 901st Hospital between Feb-ruary 2020 and March 2023 were enrolled.According to prognosis within 6 months after treatment,patients were divided into favorable outcome group and unfavorable outcome group.Serum levels of CysC,D-D and NINJ1 were measured upon admission.Multivariate Logistic regression analysis was conducted to identify the factors influencing unfavorable outcome in AMI patients.Receiver operating characteristic(ROC)curves were used to analyze the pre-dictive value of serum NINJ1,CysC and D-D for the prognosis of AMI patients.A nomogram model for predicting unfavorable outcome in AMI patients was constructed and verified.Results:Compared to patients with favorable outcomes,those with unfavorable outcomes had significantly higher proportions of hypertension,diabetes,number of diseased coronary arteries ≥2,and serum levels of NINJ1,CysC and D-D,as well as a significantly lower pro-portion of Killip class Ⅰ-Ⅱ(P<0.01 all).Multivariate Logistic regression analysis showed that number of diseased coronary arteries ≥2(OR=3.817,95%CI 1.140~12.779,P=0.030),Killip class Ⅲ-Ⅳ(OR=5.639,95%CI 1.706~18.637,P=0.005),hypertension(OR=4.188,95%CI 1.392~12.600,P=0.011),diabetes(OR=3.480,95%CI 1.148~10.552,P=0.028),and serum levels of NINJ1(OR=1.055,95%CI 1.009~1.103,P=0.018),CysC(OR=75.232,95%CI 5.537~545.908,P=0.003),and D-D(OR=56.163,95%CI 1.610~958.586,P=0.026)were significantly associated with unfavorable outcomes at 6 months in AMI patients.ROC a-nalysis showed that the AUC of serum NINJ1,CysC and D-D combined predicting unfavorable outcomes was 0.801(95%CI 0.718~0.869),which was significantly higher than those of serum NINJ1(0.675,95%CI 0.582~0.758)and D-D(0.676,95%CI 0.583~0.759)alone(Z=2.344,P=0.019;Z=2.173,P=0.030,),but the difference was not significant comparing to CysC alone(Z=1.856,P=0.064).The C-index of the nomogram model predic-ting unfavorable outcomes was 0.973(95%CI 0.967~0.986),and the predicted values of calibration curve were consistent with the actual values,indicating good prediction accuracy.Conclusion:Elevated serum levels of NINJ1,CysC and D-D in AMI patients were significantly associated with unfavorable outcomes.Combined detection of these indicators may accurately predict unfavorable outcomes compared to single detection,and the constructed no-mogram model exhibits good prediction efficacy.
5.A convenient research strategy for functional verification of epigenetic regulators during spermatogenesis.
Shan LI ; Ying YUAN ; Ke-Yu ZHANG ; Yi-Dan GUO ; Lu-Tong WANG ; Xiao-Yuan ZHANG ; Shu ZHANG ; Qi YAN ; Rong ZHANG ; Jie CHEN ; Feng-Tang YANG ; Jing-Rui LI
Asian Journal of Andrology 2025;27(2):261-267
Spermatogenesis is a fundamental process that requires a tightly controlled epigenetic event in spermatogonial stem cells (SSCs). The mechanisms underlying the transition from SSCs to sperm are largely unknown. Most studies utilize gene knockout mice to explain the mechanisms. However, the production of genetically engineered mice is costly and time-consuming. In this study, we presented a convenient research strategy using an RNA interference (RNAi) and testicular transplantation approach. Histone H3 lysine 9 (H3K9) methylation was dynamically regulated during spermatogenesis. As Jumonji domain-containing protein 1A (JMJD1A) and Jumonji domain-containing protein 2C (JMJD2C) demethylases catalyze histone H3 lysine 9 dimethylation (H3K9me2), we firstly analyzed the expression profile of the two demethylases and then investigated their function. Using the convenient research strategy, we showed that normal spermatogenesis is disrupted due to the downregulated expression of both demethylases. These results suggest that this strategy might be a simple and alternative approach for analyzing spermatogenesis relative to the gene knockout mice strategy.
Spermatogenesis/physiology*
;
Animals
;
Male
;
Mice
;
Epigenesis, Genetic
;
Jumonji Domain-Containing Histone Demethylases/metabolism*
;
Histones/metabolism*
;
RNA Interference
;
Testis/metabolism*
;
Methylation
;
Mice, Knockout
;
Histone Demethylases
6.Anti-synthetase syndrome with interstitial lung disease: clinical and skeletal muscle pathology
Jiaqi LIU ; Jing XU ; Lingya QIAO ; Mengyang LIU ; Ying LIN ; Juan CHEN ; Ke LI ; Qiang SHI
Chinese Journal of Neurology 2025;58(2):154-160
Objective:To summarize the clinical manifestations of anti-synthetase syndrome (ASS) with interstitial lung disease (ILD) patients with different antibody subtypes and the skeletal muscle pathology of ASS.Methods:A total of 106 ASS-ILD patients admitted to the First Medical Center of Chinese People′s Liberation Army General Hospital from May 11, 2015 to June 25, 2023 were included. Their intramuscular and extramuscular clinical manifestations were collected. The correlation between different antibody subtypes in patients with ASS and the various subtypes of ILD was investigated. The skeletal muscle pathological characteristics of 13 ASS patients were also summarized.Results:Among the 106 ASS-ILD patients, 56 (52.8%) were anti-JO-1 antibody positive, 19 (17.9%) were anti-PL-7 antibody positive, 11 (10.4%) were anti-PL-12 antibody positive, 14 (13.2%) were anti-EJ antibody positive, and 6 (5.7%) were anti-OJ antibody positive. All the patients had ILD [including nonspecific interstitial pneumonia (NSIP), usual interstitial pneumonia (UIP), organizing pneumonia (OP), mixed pneumonia]. In all the patients, 46.2% (49/106) had cardiac damage, 37.7% (40/106) had arthritis, 29.2% (31/106) had myasthenia gravis, 24.5% (26/106) had myalgia, and 19.8% (21/106) had Raynaud′s phenomenon. The incidence of NSIP was 75.0% (42/56) in the anti-JO-1 antibody-positive group, significantly higher than other groups (anti-PL-7 antibody-positive group, 8/19;anti-PL-12 antibody-positive group, 3/11;anti-EJ antibody-positive group, 5/14;anti-OJ antibody-positive group, 2/6; P=0.001). UIP was most common in the anti-PL-7 antibody-positive group (8/19). OP was most frequent in the anti-PL-12 antibody-positive group (5/11). The incidence of arthritis was highest in the anti-JO-1 antibody-positive group (51.8%, 29/56). The anti-Ro-52 antibody-positive rate was significantly higher in the anti-EJ antibody-positive group (12/14) than in the other 4 groups [anti-JO-1 antibody-positive group, 33.9% (19/56); anti-PL-7 antibody-positive group, 10/19; anti-PL-12 antibody-positive group, 6/11; anti-OJ antibody-positive group, 0/6; P=0.001]. ASS skeletal muscle pathology was manifested as necrotizing myopathy pattern (6/13), inflammatory myopathy pattern (4/13), and nonspecific myopathy pattern (3/13). All the 106 patients received methylprednisolone as the basic treatment. Among them, 69 patients (65.1%) received methylprednisolone alone, while 37 patients (34.9%) received combination therapy involving immunosuppressants, whose symptoms improved after treatment. Conclusions:A discernible correlation exists between the clinical manifestations of ASS with ILD and specific antibody subtypes. ASS patients generally respond well to immunotherapy. ASS can manifest as 3 distinct skeletal muscle pathological patterns: necrotizing myopathy pattern, inflammatory myopathy pattern, and nonspecific myopathy pattern.
7.Analysis of Predictive Factors for the Efficacy of Traditional Chinese Medicine in Treating Myasthenia Gravis and Development and Validation of the Nomogram Model
Ke WANG ; Xinchen JI ; Ying ZHANG ; Jing LU ; Baitong WANG ; Dongmei ZHANG ; Peng XU ; Jian WANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(3):674-682
Objective To explore the relevant factors affecting the efficacy of traditional Chinese medicine in treating MG,and to develop and validate a nomogram model,in order to personalize the prediction of the probability of benefits for MG patients after traditional Chinese medicine treatment,further guide clinical physicians in targeted medication,and provide guidance for the traditional Chinese medicine treatment of MG.Method Retrospective analysis of MG patients who visited the Affiliated Hospital of Changchun University of Traditional Chinese Medicine from March 2018 to June 2022,13 clinical factors were selected to evaluate the results.To acquire independent factors,univariate and multivariate Logistic analyses were performed.The area under the receiver operating characteristic curve,Harrell's concordance index,calibration curve,and decision curve analyses were used to evaluate the predictive ability,accuracy,and clinical practicability of the prediction model.Results A total of 204 cases were included,divided into derivation cohort 139 cases and temporal validation cohort 65 cases.Multivariate Logistic regression showed 4 independent predictors affecting effectiveness of traditional Chinese medicine in treating MG,including age at onset,repetitive nerve stimulation positive,oral immunosuppressant and anxiety/depression.AUC values for the model group and validation group were 0.76(95%CI:0.68-0.84)and 0.83(95%CI:0.71-0.95),respectively,and based on calibration curve and decision curve analysis,we concluded that the nomogram showed excellent performance.Conclusion MG patients may experience a decrease in short-term efficacy with age,positive RNS,concomitant emotional abnormalities,or recent history of immunosuppressive therapy.This nomogram effectively predicts the possibility of short-term effective traditional Chinese medicine treatment in MG patients.
8.Analysis of Predictive Factors for the Efficacy of Traditional Chinese Medicine in Treating Myasthenia Gravis and Development and Validation of the Nomogram Model
Ke WANG ; Xinchen JI ; Ying ZHANG ; Jing LU ; Baitong WANG ; Dongmei ZHANG ; Peng XU ; Jian WANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(3):674-682
Objective To explore the relevant factors affecting the efficacy of traditional Chinese medicine in treating MG,and to develop and validate a nomogram model,in order to personalize the prediction of the probability of benefits for MG patients after traditional Chinese medicine treatment,further guide clinical physicians in targeted medication,and provide guidance for the traditional Chinese medicine treatment of MG.Method Retrospective analysis of MG patients who visited the Affiliated Hospital of Changchun University of Traditional Chinese Medicine from March 2018 to June 2022,13 clinical factors were selected to evaluate the results.To acquire independent factors,univariate and multivariate Logistic analyses were performed.The area under the receiver operating characteristic curve,Harrell's concordance index,calibration curve,and decision curve analyses were used to evaluate the predictive ability,accuracy,and clinical practicability of the prediction model.Results A total of 204 cases were included,divided into derivation cohort 139 cases and temporal validation cohort 65 cases.Multivariate Logistic regression showed 4 independent predictors affecting effectiveness of traditional Chinese medicine in treating MG,including age at onset,repetitive nerve stimulation positive,oral immunosuppressant and anxiety/depression.AUC values for the model group and validation group were 0.76(95%CI:0.68-0.84)and 0.83(95%CI:0.71-0.95),respectively,and based on calibration curve and decision curve analysis,we concluded that the nomogram showed excellent performance.Conclusion MG patients may experience a decrease in short-term efficacy with age,positive RNS,concomitant emotional abnormalities,or recent history of immunosuppressive therapy.This nomogram effectively predicts the possibility of short-term effective traditional Chinese medicine treatment in MG patients.
9.Predictive value of serum NINJ1,CysC and D-D for unfavorable outcomes in patients with acute myo-cardial infarction
Ke CHEN ; Jing-ying WANG ; Min XU ; Hong-yan YANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2025;34(4):521-526
Objective:To investigate the predictive value of serum levels of Ninjurin 1(NINJ1),cystatin C(CysC),and D-dimer(D-D)for unfavorable outcomes in patients with acute myocardial infarction(AMI).Methods:A total of 118 AMI patients hospitalized in the Chinese PLA Joint Logistic Support Force 901st Hospital between Feb-ruary 2020 and March 2023 were enrolled.According to prognosis within 6 months after treatment,patients were divided into favorable outcome group and unfavorable outcome group.Serum levels of CysC,D-D and NINJ1 were measured upon admission.Multivariate Logistic regression analysis was conducted to identify the factors influencing unfavorable outcome in AMI patients.Receiver operating characteristic(ROC)curves were used to analyze the pre-dictive value of serum NINJ1,CysC and D-D for the prognosis of AMI patients.A nomogram model for predicting unfavorable outcome in AMI patients was constructed and verified.Results:Compared to patients with favorable outcomes,those with unfavorable outcomes had significantly higher proportions of hypertension,diabetes,number of diseased coronary arteries ≥2,and serum levels of NINJ1,CysC and D-D,as well as a significantly lower pro-portion of Killip class Ⅰ-Ⅱ(P<0.01 all).Multivariate Logistic regression analysis showed that number of diseased coronary arteries ≥2(OR=3.817,95%CI 1.140~12.779,P=0.030),Killip class Ⅲ-Ⅳ(OR=5.639,95%CI 1.706~18.637,P=0.005),hypertension(OR=4.188,95%CI 1.392~12.600,P=0.011),diabetes(OR=3.480,95%CI 1.148~10.552,P=0.028),and serum levels of NINJ1(OR=1.055,95%CI 1.009~1.103,P=0.018),CysC(OR=75.232,95%CI 5.537~545.908,P=0.003),and D-D(OR=56.163,95%CI 1.610~958.586,P=0.026)were significantly associated with unfavorable outcomes at 6 months in AMI patients.ROC a-nalysis showed that the AUC of serum NINJ1,CysC and D-D combined predicting unfavorable outcomes was 0.801(95%CI 0.718~0.869),which was significantly higher than those of serum NINJ1(0.675,95%CI 0.582~0.758)and D-D(0.676,95%CI 0.583~0.759)alone(Z=2.344,P=0.019;Z=2.173,P=0.030,),but the difference was not significant comparing to CysC alone(Z=1.856,P=0.064).The C-index of the nomogram model predic-ting unfavorable outcomes was 0.973(95%CI 0.967~0.986),and the predicted values of calibration curve were consistent with the actual values,indicating good prediction accuracy.Conclusion:Elevated serum levels of NINJ1,CysC and D-D in AMI patients were significantly associated with unfavorable outcomes.Combined detection of these indicators may accurately predict unfavorable outcomes compared to single detection,and the constructed no-mogram model exhibits good prediction efficacy.
10.Expert consensus on intraoperative repositioning for patients with spine fracture and dislocation (version 2025)
Dongmei BIAN ; Ke SUN ; Ningbo CHEN ; Caixia BAI ; Miao WANG ; Yafeng QIAO ; Fei WANG ; Hong WANG ; Feng TIAN ; Mei YAN ; Meng BAI ; Linjuan ZHANG ; Liyan ZHAO ; Yaqing CUI ; Xue JIANG ; Leling FENG ; Ning NING ; Junqin DING ; Lan WEI ; Yonghua ZHAI ; Yu ZENG ; Zengmei ZHANG ; Jiqun HE ; Fenggui BIE ; Hong CHEN ; Zengyan WANG ; Li LI ; Li ZHANG ; Yaying ZHOU ; Bing SHAO ; Ying WANG ; Caixia XIE ; Yanfeng YAO ; Jingjing AN ; Wen SHI ; Xiongtao LIU ; Xiaoyan AN ; Ning NAN ; Lan LI ; Xiaohui GOU ; Qiaomei LI ; Xiuting WU ; Yuqin ZHANG ; Jing LIU ; Fusen XIANG ; Xu XU ; Na MEI ; Jiao ZHOU ; Shan FAN ; Qian WANG ; Shuixia LI
Chinese Journal of Trauma 2025;41(2):138-147
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.

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