Objectives:To evaluate the clinical efficacies of robot-assisted versus C-arm fluoroscopy-guided percutaneous pedicle screw fixation for thoracolumbar burst fractures.Methods:A retrospective analysis was conducted on 46 patients(26 males,20 females;age 27-69 years)with thoracolumbar burst fractures treated between January 2022 and December 2023.The patients were divided into the observation group of 21 cases(12 males,9 females;52.1±8.8 years)receiving robot-assisted navigation,and the control group of 25 cases(14 males,11 females;50.9±13.2 years)undergoing conventional C-arm fluoroscopy guidance.No significant differences were observed in baseline characteristics(case number,sex ratio,BMI;P＞0.05).Both groups of patients underwent percutaneous pedicle screw internal fixation of the injured vertebra.Intraoperative parameters(fluoroscopy frequency,operative time,blood loss),postoperative CT scans on 3d(assessed by Gertzbein-Robbins scale for screw placement accuracy),pre-and postoperative pain VAS scores(thoracolumbar back pain before surgery and at 1d,3d,and 1 month after surgery),and radiographic parameters(Cobb angle,anterior vertebral body height ratio at preoperation,and postoperative 3d,1 month,and 6 months)were recorded and compared using t-tests and Mann-Whitney U tests.Results:The observation group demonstrated significantly shorter operative time(90.71±9.52min vs 117.62±16.63min,P＜0.05),reduced blood loss(67.14±18.75mL vs 139.52±28.01mL,P＜0.05),and fewer fluoroscopy exposures(9.14±2.27 vs 18.86±2.86,P＜0.05)than the control group.No complications occurred during follow-up in both groups.The observation group exhibited superior screw placement accuracy(98.4％vs 90.7％,P＜0.05)with 124/126 screws graded as excellent/good versus 136/150 in controls.Postoperative pain VAS scores were lower in the observation group on 1d(2.67±0.57 vs 4.00±0.70,P＜0.05)and 3d(1.19±0.68 vs 1.95±0.59,P＜0.05),but comparable at 1 month(0.76±0.43 vs 1.10±0.53,P＞0.05).The postoperative 3d,1 month and 6 months'Cobb angles(6.08°±1.49° vs 6.09°±1.05°,6.26°±1.46° vs 6.28°±1.14°,6.78°±1.38° vs 6.91°±1.31°)and anterior vertebral height ratios[(90.14±1.56)％vs(90.06±1.69)％,(89.62±1.56)％vs(89.44±2.12)％,(88.87±1.72)％vs(88.92±1.88)％]showed no significant in-tergroup differences at different time points(P＞0.05).Conclusions:Robot-assisted percutaneous pedicle screw fixation for the treatment of thoracolumbar burst fractures has significant advantages in improving surgical ac-curacy,reducing intraoperative blood loss,shortening operative time,and decreasing the number of fluoroscopic exposures.

Objective:To search, evaluate, and summarize the best evidence for postpartum contraceptive health guidance, providing evidence-based support for clinical healthcare providers in implementing standardized contraceptive counseling and management.Methods:A systematic search was conducted across guideline repositories, professional association websites, and databases for literature related to postpartum contraception guidance, including guidelines, best practices, expert consensus, and systematic reviews, with a search timeframe from database inception to December 2023. Four researchers independently evaluated the quality of the included studies, extracted relevant data, and synthesized evidence from eligible literature.Results:According to the inclusion and exclusion criteria, 18 documents were included, comprising 5 guidelines, 2 clinical decision-making documents, 1 best practice document, 4 expert consensus statements, and 6 meta-analyses or systematic reviews. Totally 46 pieces of best evidence were summarized from 9 aspects, including health educators, health education recipients, assessment, planning, mode and content of health education, available contraceptive methods, evaluation index of health education, and considerations.Conclusion:This study systematically synthesizes the best available evidence on postpartum contraceptive health guidance. It emphasizes strengthening the competencies of clinical practitioners, supported by structured assessments and standardized guidance, to improve the feasibility and accessibility of contraceptive services. It further highlights the importance of ensuring the long-term sustainability of contraceptive plans and integrating digital tools to enhance the precision and coverage of guidance, ultimately reducing unintended and short-interval pregnancies and safeguarding women's reproductive health.

Objectives:To evaluate the clinical efficacies of robot-assisted versus C-arm fluoroscopy-guided percutaneous pedicle screw fixation for thoracolumbar burst fractures.Methods:A retrospective analysis was conducted on 46 patients(26 males,20 females;age 27-69 years)with thoracolumbar burst fractures treated between January 2022 and December 2023.The patients were divided into the observation group of 21 cases(12 males,9 females;52.1±8.8 years)receiving robot-assisted navigation,and the control group of 25 cases(14 males,11 females;50.9±13.2 years)undergoing conventional C-arm fluoroscopy guidance.No significant differences were observed in baseline characteristics(case number,sex ratio,BMI;P＞0.05).Both groups of patients underwent percutaneous pedicle screw internal fixation of the injured vertebra.Intraoperative parameters(fluoroscopy frequency,operative time,blood loss),postoperative CT scans on 3d(assessed by Gertzbein-Robbins scale for screw placement accuracy),pre-and postoperative pain VAS scores(thoracolumbar back pain before surgery and at 1d,3d,and 1 month after surgery),and radiographic parameters(Cobb angle,anterior vertebral body height ratio at preoperation,and postoperative 3d,1 month,and 6 months)were recorded and compared using t-tests and Mann-Whitney U tests.Results:The observation group demonstrated significantly shorter operative time(90.71±9.52min vs 117.62±16.63min,P＜0.05),reduced blood loss(67.14±18.75mL vs 139.52±28.01mL,P＜0.05),and fewer fluoroscopy exposures(9.14±2.27 vs 18.86±2.86,P＜0.05)than the control group.No complications occurred during follow-up in both groups.The observation group exhibited superior screw placement accuracy(98.4％vs 90.7％,P＜0.05)with 124/126 screws graded as excellent/good versus 136/150 in controls.Postoperative pain VAS scores were lower in the observation group on 1d(2.67±0.57 vs 4.00±0.70,P＜0.05)and 3d(1.19±0.68 vs 1.95±0.59,P＜0.05),but comparable at 1 month(0.76±0.43 vs 1.10±0.53,P＞0.05).The postoperative 3d,1 month and 6 months'Cobb angles(6.08°±1.49° vs 6.09°±1.05°,6.26°±1.46° vs 6.28°±1.14°,6.78°±1.38° vs 6.91°±1.31°)and anterior vertebral height ratios[(90.14±1.56)％vs(90.06±1.69)％,(89.62±1.56)％vs(89.44±2.12)％,(88.87±1.72)％vs(88.92±1.88)％]showed no significant in-tergroup differences at different time points(P＞0.05).Conclusions:Robot-assisted percutaneous pedicle screw fixation for the treatment of thoracolumbar burst fractures has significant advantages in improving surgical ac-curacy,reducing intraoperative blood loss,shortening operative time,and decreasing the number of fluoroscopic exposures.

OBJECTIVE This study investigated the clinical implications of endothelial cell-specific molecule 1(ESM-1)in obstructive sleep apnea(OSA)patients,with particular focus on its dynamic correlation with adhesion molecules,aiming to elucidate the regulatory role of ESM-1 in OSA-associated vascular endothelial impairment.METHODS This cross-sectional study enrolled participants undergoing polysomnography(PSG)at the Sleep Medicine Center of Beijing Anzhen Hospital,Capital Medical University between March 2017 and January 2018.Based on the inclusion criteria,161 participants were ultimately included and divided into OSA group(n=118)and control group(n=43).Demographic data and polysomnography parameters were collected.We used a powerful high-throughput Multiplex Immunobead Assay technology to simultaneously test plasm cytokines levels of ESM-1,inter-cellular adhesion molecule 1(ICAM-1),vascular cell adhesion molecule 1(VCAM-1).Circulating C-reactive protein(CRP)and homocysteine(Hcy)were detected by routine blood chemistry panel.RESULTS Circulating ESM-1 levels were significantly elevated in patients with OSA compared with healthy controls[819.73(612.36-1393.47)pg/ml]vs.[286.17(114.48-513.81)pg/ml,P<0.001].After adjusting for confounding factors,we found that circulating ESM-1 levels were an independent risk factor for OSA(odds ratio=2.162,95%CI=1.522-3.072,P<0.001)and circulating ESM-1 levels were positively associated with ICAM-1 and VCAM-1 levels(β=1.977,95%CI=1.429-2.734,P<0.001).CONCLUSION Circulating ESM-1 levels were significantly increased in patients with OSA,which is closely related with adhesion molecules levels.ESM-1 may be a surrogate endothelial dysfunction marker and an independent risk factor for OSA.

Objective:To search, evaluate, and summarize the best evidence for postpartum contraceptive health guidance, providing evidence-based support for clinical healthcare providers in implementing standardized contraceptive counseling and management.Methods:A systematic search was conducted across guideline repositories, professional association websites, and databases for literature related to postpartum contraception guidance, including guidelines, best practices, expert consensus, and systematic reviews, with a search timeframe from database inception to December 2023. Four researchers independently evaluated the quality of the included studies, extracted relevant data, and synthesized evidence from eligible literature.Results:According to the inclusion and exclusion criteria, 18 documents were included, comprising 5 guidelines, 2 clinical decision-making documents, 1 best practice document, 4 expert consensus statements, and 6 meta-analyses or systematic reviews. Totally 46 pieces of best evidence were summarized from 9 aspects, including health educators, health education recipients, assessment, planning, mode and content of health education, available contraceptive methods, evaluation index of health education, and considerations.Conclusion:This study systematically synthesizes the best available evidence on postpartum contraceptive health guidance. It emphasizes strengthening the competencies of clinical practitioners, supported by structured assessments and standardized guidance, to improve the feasibility and accessibility of contraceptive services. It further highlights the importance of ensuring the long-term sustainability of contraceptive plans and integrating digital tools to enhance the precision and coverage of guidance, ultimately reducing unintended and short-interval pregnancies and safeguarding women's reproductive health.

Objective:To systematically integrate qualitative research on contraceptive experiences of women within two years postpartum to clarify their needs and provide an evidence for developing subsequent support programs for reproductive planning.Methods:We searched 7 English databases, including PubMed, the Cochrane Library, Embase, Web of Science, PsycINFO, Scopus, CHIAHL, and four Chinese databases, including China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data, and VIP Database. Qualitative research studies on postpartum women's contraceptive experiences were collected. The search was conducted up to April 30, 2023. The Australian JBI (Joanna Briggs Institute) qualitative research quality assessment criteria was used for quality evaluation, and the convergent synthesis method was employed for result integration.Results:According to the inclusion and exclusion criteria, a total of 17 studies were included from 1 488 relevant literatures retrieved, with 1 251 postpartum women.Totally 41 findings were categorized into 11 themes and further consolidated into four integrated results: variations in women's awareness of contraceptive during the interpregnancy interval, diversity in women's contraceptive information needs, multifactorial influences on contraceptive decision-making, and practical challenges in accessing postpartum contraceptive support.Conclusion:Women's contraceptive needs within 2 years postpartum exhibit diverse characteristics. Healthcare professionals should thoroughly assess their needs to provide personalized contraceptive services. Simultaneously, encouraging active male involvement and leveraging multi-dimensional, sustained support from family, hospitals, and the community is essential to enhance reproductive health and ensure the well-being of women and children.

OBJECTIVE To investigate the effects of catalpol on H2O2-induced osteoblast injury and its mechanism. METHODS The osteoblasts MC3T3-E1 were separated into control group， model group， empty group （transfected with empty plasmid）， catalpol group （100 μmol/L）， catalpol+forkhead box O3 （FoxO3） overexpression group （100 μmol/L catalpol+ transfected with FoxO3 overexpression plasmid）. After catalpol treatment and transfection， except for control group， other groups were induced with H2O2 to establish osteoblast oxidative stress model. The cell viability， apoptotic rate， alkaline phosphatase （ALP） activity， optical density （OD） value of calcium nodule， mean fluorescence intensity （MFI） of reactive oxygen species （ROS）， antioxidant enzyme activity [superoxide dismutase （SOD）， catalase （CAT）]， the levels of inflammatory factors [interleukin-6 （IL-6）， IL-1β]， and the expressions of FoxO3/Wnt/β-catenin signaling pathway-related proteins were detected in each group. RESULTS Compared with the control group， the cell viability， ALP activity， OD value of calcium nodule， activities of antioxidant enzyme， and the protein expressions of Wnt and β-catenin were decreased significantly in the model group， while apoptotic rate， MFI levels of ROS， inflammatory factor levels and the protein expression of FoxO3 were all increased significantly （P＜0.05）. Compared with the model group， above indicators of the empty group had no significant change （P＞0.05）， while those of catalpol group were reversed significantly （P＜0.05）. Compared with the catalpol group， the reversal effect of the changes in the above indicators was significantly weakened in the catalpol+FoxO3 overexpression group cells （P＜0.05）. CONCLUSIONS Catalpol can activate Wnt/β-catenin signaling pathway by down-regulating FoxO3， thereby inhibiting H2O2-induced MC3T3-E1 oxidative stress and inflammation reaction， enhancing cell viability and osteogenic differentiation activity， and alleviating apoptosis injury.

Objective:To systematically integrate qualitative research on contraceptive experiences of women within two years postpartum to clarify their needs and provide an evidence for developing subsequent support programs for reproductive planning.Methods:We searched 7 English databases, including PubMed, the Cochrane Library, Embase, Web of Science, PsycINFO, Scopus, CHIAHL, and four Chinese databases, including China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data, and VIP Database. Qualitative research studies on postpartum women's contraceptive experiences were collected. The search was conducted up to April 30, 2023. The Australian JBI (Joanna Briggs Institute) qualitative research quality assessment criteria was used for quality evaluation, and the convergent synthesis method was employed for result integration.Results:According to the inclusion and exclusion criteria, a total of 17 studies were included from 1 488 relevant literatures retrieved, with 1 251 postpartum women.Totally 41 findings were categorized into 11 themes and further consolidated into four integrated results: variations in women's awareness of contraceptive during the interpregnancy interval, diversity in women's contraceptive information needs, multifactorial influences on contraceptive decision-making, and practical challenges in accessing postpartum contraceptive support.Conclusion:Women's contraceptive needs within 2 years postpartum exhibit diverse characteristics. Healthcare professionals should thoroughly assess their needs to provide personalized contraceptive services. Simultaneously, encouraging active male involvement and leveraging multi-dimensional, sustained support from family, hospitals, and the community is essential to enhance reproductive health and ensure the well-being of women and children.

Objective:To compare the clinical effects of discectomy combined with transpedicular dynamic stabilization and transforaminal lumbar interbody fusion (TLIF) in treating single-level lumbar disc herniation.Methods:From November 2012 to November 2015, a total of 96 patients with single-level lumbar disc herniation (disc height decreased more than 1/3, the width of the basilar part of the herniated disc >6 mm, massive disc herniation or Modic type I endplate changes) treated by discectomy combined with Dynesys dynamic stabilization (Dynesys group, n=48) or TLIF (fusion group, n=48) were enrolled. Clinical assessments included operation duration, intraoperative blood loss, MacNab score, visual analogue scale (VAS), Oswestry disability index (ODI) and rate of complications. Radiographs were evaluated for lumbar mobility, intervertebral height, etc. Results:A total of 86 patients were included in the final analysis (44 in Dynesys group and 42 in fusion group) and were evaluated after 5 years follow-up. The operation duration of Dynesys group (159.61±37.29 min) was less than that of the fusion group (177.42±39.90 min) significantly ( t=2.140, P=0.035). Intraoperative blood loss in Dynesys group (151.78±50.88 ml) was less than that in fusion group (197.74±76.55 ml) with significant difference ( t=3.293, P=0.001). At 5 years follow-up, there were 2 cases with screw loosening and 5 cases with adjacent segmental degeneration in Dynesys group without symptom. In fusion group, there were 12 cases with adjacent segmental degeneration and two of them with symptom. There were significant differences in the incidence of adjacent segment degeneration between the two groups ( χ2=4.012, P=0.045). According to the MacNab criteria, excellent or good cases accounted for 95% in Dynesys group and 93% in fusion group without significant differences ( Z=0.425, P=0.671). VAS back, VAS leg and ODI scores were improved significantly in both groups after 2 years and 5 years ( P<0.05). However, there were no significant differences between the two groups ( P<0.05). The activity of the surgical segment was 4.59°±0.48° in Dynesys group and 1.00°±0.42° in fusion group at 5 years after surgery. The height of intervertebral space in Dynesys group decreased from 11.19±2.07 mm before surgery to 9.98±2.02 mm at 2 years after surgery and to 9.86±1.64 mm at 5 years after surgery ( F=6.462, P=0.002). However, there was no statistically significant difference between the 2 and 5 years follow-up ( q=0.415, P>0.05). At 5 years after surgery, the activity of the first proximal segment in the two groups was 9.74°±3.29° and 11.69°±3.89°, respectively ( t=2.514, P=0.014). Conclusion:Both discectomy combined with dynamic stabilization and TLIF can achieve satisfied clinical effects in treating single-level lumbar disc herniation. Dynamic stabilization preserves the intervertebral activity of surgical segments and results in a lower incidence of adjacent segment degeneration compared with that in fusion surgery. Furthermore, discectomy combined with dynamic stabilization is a less invasive intervention with shorter operation duration and less blood loss compared with TLIF.

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.
Adult ; Asian Continental Ancestry Group ; Biomarkers ; China ; Consensus ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Eosinophils ; Epidemiology ; Epigenomics ; Genetics ; Humans ; Hypersensitivity ; Inflammation ; International Agencies ; Medical Staff ; Neck ; Phenotype ; Precision Medicine