Objective: To analyze the cause of discrepancy between ABO genotype B102/O01 and serological results in one case by PCR-SSP, to clarify the serological characteristics of this special blood group, and to explore relevant blood transfusion strategies. Methods: Blood group serological tests were performed on blood donor in August and December 2024, including forward and reverse ABO typing using tube method, H antigen identification, direct anti-human globulin test by tube method, red blood cell absorption-elution test, and determination of ABH blood group substance in saliva. Exons 1-7 of the ABO gene were amplified by PCR-SSP and sequenced. Results: The two separate serological tests consistently identified the donor as having an A B phenotype, but the results of gene sequencing indicated a B102/O01 genotype, showing an discrepancy between serological and genetic results. Conclusion: It is very likely that the blood type of the blood donor is B102/O01 with a microchimerism of type A, or an AB type masked by A type reference gene.

ObjectiveTo investigate the mechanism underlying the weight loss effect of electrothermal acupuncture （ETA） in diet-induced obese （DIO） model mice based on the hypoxia-inducible factor-1α （HIF-1α）/sphingosine-1-phosphate （S1P）sphingosine-1-phosphate receptor 3 （S1PR3） signaling pathway-mediated macrophage polarization. MethodsAn obesity mouse model was established by continuously feeding at a high-fat diet （HFD） for 8 weeks. Twenty successfully modeled obese mice were randomly divided into a model group and an electrothermal acupuncture （ETA） group with 10 mice per group， both of which continued to receive the HFD till week 12. Another 10 mice were assigned to the normal group and fed a standard chow diet continuously for 12 weeks. Starting from week 9 of the experiment， mice in the ETA group received electrothermal acupuncture stimulation at Zhongwan （CV12）， bilateral Tianshu （ST25）， and bilateral Zusanli （ST36） for 30 minutes per session， with the instrument current set at （40±0.5）mA and a constant temperature of （40±0.5）℃. Mice in the normal group and the model group were restrained in the same manner for 30 minutes without acupuncture. All interventions were performed once every other day for a total of 4 weeks. Ten hours after the final intervention， the body weight， waist circumference， and body length of mice in each group were measured， and Lee's index was calculated. Serum biochemical analysis was performed to assess fasting blood glucose （FBG）， total cholesterol （TC）， triglycerides （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， blood urea nitrogen （BUN）， and creatinine （Cr）. Serum leptin （LEP） and adiponectin （ADPN） levels， as well as sphingosine-1-phosphate （S1P） levels in epididymal white adipose tissue （eWAT）， were detected by ELISA. Histomorphological changes in eWAT were monitored via HE staining. Flow cytometry was used to analyze macrophage subtype-related indexes in eWAT， including the total proportion of macrophages， the proportion of M1 macrophages， the proportion of M2 macrophages， and the M1/M2 ratio. Antibody array technology was used to determine the levels of differentially expressed inflammatory factors in eWAT between the model and blank groups， as well as between the ETA and model groups. Western blot and qPCR were used to detect the protein and mRNA expression levels of HIF-1α and S1PR3 in the eWAT， respectively. ResultsCompared to the normal group， the model group showed significantly increased body weight， Lee's index， waist circumference， and FBG， TC， TG， HDL-C， LDL-C， AST， and ALT levels， upgraded LEP and S1P levels， decreased ADPN level and ADPN/LEP ratio， elevated proportion of M1 macrophages and the M1/M2 ratio， reduced proportion of M2 macrophages， and upregulated protein and mRNA expression levels of HIF-1α and S1PR3 （P＜0.05 or P＜0.01）. With the exception of HDL-C， all the abovementioned indicators in the ETA group were significantly improved compared to the model group （P＜0.05 or P＜0.01）. Analysis of differentially expressed inflammatory cytokines revealed that， compared to the normal group， the levels of interleukin-1β （IL-1β）， interferon-γ （IFN-γ）， interleukin-6 （IL-6）， and interleukin-12p70 （IL-12p70） in the eWAT of the model group were elevated； conversely， the levels of interleukin-17 （IL-17）， interleukin-5 （IL-5）， IL-6， and interleukin-23 （IL-23） in the eWAT of the ETA group decreased compared to the model group （P＜0.05 or P＜0.01）. ConclusionETA exerts a weight-reducing effect in obese model mice， and the mechanism may involve inhibition of the HIF-1α/S1P/S1PR3 signaling pathway activation， which shifts macrophage polarization from the M1 to M2 phenotype， thereby alleviating chronic inflammation.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Thoracolumbar spine fracture often leads to severe pain, functional impairments, and neurological deficits, for which open reduction and internal fixation can effectively restore the spinal structural stability. Open decompression and reduction with internal fixation can help relieve spinal cord compression and improve spinal function in cases of concomitant cord injury. Although spinal stability can be restored through surgery, patients often face chronic pain and functional impairments postoperatively. A postoperative rehabilitation program is critical in optimizing therapeutic outcomes, reducing complications, and minimizing the risk of secondary injuries. However, current rehabilitation methods, such as physical therapy, functional training, and pain management, are confronted with problems in clinical practice, including significant variation in efficacy, poor patient adherence, and prolonged rehabilitation period. There is an urgent need for a unified rehabilitation strategy to address these problems. To this end, the Spinal Trauma Group of the Orthopedic Physicians Branch of the Chinese Medical Association and the Spine Health Professional Committee of the Chinese Human Health Technology Promotion Association organized experts from relevant fields to formulate Evidence-based guidelines for rehabilitation treatment after internal fixation of thoracolumbar spine fracture in adults ( version 2025) by integrating evidences from clinical researches and advanced rehabilitation concepts at home and abroad. A total number of 14 recommendations concerning the rehabilitation treatment with multimodal analgesia, psychological intervention, deep vein thrombosis prevention, core muscle and extremity exercise, appropriate use of braces, early weight-bearing, device-aided rehabilitation exercise, neuroregulatory therapy, rehabilitation team were put forward, aiming to standardize the post-operative rehabilitation process following internal fixation, promote the functional recovery, and enhance patients′ quality of life.

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:To evaluate the effect of dexmedetomidine on Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor κB (NF-κB) signaling pathway in the hippocampus of mice with cognitive impairment after traumatic brain injury (TBI).Methods:Sixty specific pathogen-free healthy adult wild-type C57BL/6 mice, aged 21-23 months, weighing 28-34 g, were divided into 5 groups ( n=12 each) by a random number table method: sham operation + vehicle group (SV group), sham operation + dexmedetomidine group (SD group), TBI + vehicle group (TV group), TBI + dexmedetomidine group (TD group) and TBI + TLR4 inhibitor TAK-242 group (TT group). The modified Feeney free fall epidural impact method was used to establish a mild TBI model. At 30 min before model preparation, dexmedetomidine 25 μg/kg was intraperitoneally injected in SD group and TD group, TAK-242 10 mg/kg was intraperitoneally injected in TT group, and the equal volume of normal saline was intraperitoneally injected in SV group and TV group. Neurological severity scores (NSSs) were used to evaluate the neurological function at 1, 7 and 14 days after developing the model. The novel object recognition test (recognition index) and fear conditioning test (the percentage of freezing time related to context and sound) were used to evaluate the cognitive function of mice at 16 days after developing the model. The number and morphology of hippocampal neurons (NeuN-positive cells) and activated microglia (ionized calcium-binding adaptor molecule 1[IBA1]-positive cells) were measured by immunofluorescent staining. The expression of interleukin-1beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α), TLR4, MyD88 and nuclear factor kappa B (NF-κB) was detected by Western blot. Results:Compared with SV group, the NSS was significantly increased, the recognition index was decreased, the percentage of freezing time related to context and sound was decreased, the number of NeuN-positive cells was decreased, the number of IBA1-positive cells was increased and the cell body area was enlarged, the total branch length and intersection points were decreased, and the expression of TLR4, MyD88, NF-κB, IL-1β, IL-6 and TNF-α was up-regulated in TV group ( P<0.05). Compared with TV group, the NSS was significantly decreased, the recognition index was increased, the percentage of freezing time related to context and sound was increased, the number of NeuN-positive cells was increased, the number of IBA1-positive cells was decreased and the cell body area was reduced, the total branch length and intersection points were increased, and the expression of TLR4, MyD88, NF-κB, IL-1β, IL-6 and TNF-α was down-regulated in TD group and TT group ( P<0.05). There was no statistically significant difference in the aforementioned parameters between TD group and TT group ( P>0.05). Conclusions:The mechanism by which dexmedetomidine mitigates TBI-induced cognitive impairment may be related to inhibition of the hippocampal TLR4/MyD88/NF-κB signaling pathway and reduction of neuroinflammatory responses in mice.

Objective To investigate the long-term efficacy and postoperative complications of artificial urinary sphincter (AUS) implantation in patients with stress urinary incontinence caused by traumatic urethral injury, so as to provide reference for the treatment of this condition. Methods A retrospective study was conducted on the clinical data of 26 patients treated at our center during Apr.2002 and Dec.2024. All patients had severe persistent urinary incontinence due to traumatic urethral injury and underwent AUS implantation. The daily pad usage and visual analog scale (VAS) scores before surgery and 6 months to 1 year after surgery were compared to evaluate the efficacy. Complications were recorded and analyzed, and the survival was analyzed using the Kaplan-Meier method. Results The patients included 25 males and 1 female, with a mean age (41.8± 16.0) years, median disease duration of 10.0 (2.0,16.0) years and follow-up of (11.7±5.9) years. One month postoperatively, all patients successfully activated the AUS device. At the latest follow-up (Jun.2025),20 devices (including 3 revised) were functioning. The social continence rate was 61.5% (16/26), and complete continence rate 38.5% (10/26). Daily pad usage decreased significantly from a preoperative median of 3.5 (3.0,5.0) pads/day to 0.5 (0,1.0) pads/day (P<0.05). The median VAS score decreased from 8.0 (7.0,8.0) to 1.0 (0,1.0) (P<0.05). Complications occurred in 34.6% (9/26) patients, including urethral erosion (4 cases), fluid leakage (3 cases) and infection (2 cases). There was a significantly difference in age between patients with complications and those without complications [ (33.1±12.3) years vs. (46.4±16.1) years, P<0.05]. The median survival was 16 years, with the 5-year,10-year, and 15-year survival probabilities of 75.8%, 75.8% and 58.3%. Conclusion AUS implantation demonstrates good long-term efficacy and durability, and is a recommended treatment option.

Objective To explore the effects of home-based exercise rehabilitation on cardiac structure, valvular function, and exercise capacity in patients with severe aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR). Methods 49 patients with severe AS who underwent TAVR at Zhongshan Hospital, Fudan University, from January 2024 to February 2025 were enrolled. They were divided into an exercise group (n＝25) or a non-exercise group (n＝24) based on participating or not in home-based rehabilitation after TAVR. The exercise group received 12 weeks of home-based exercise training (aerobic exercise plus resistance training every week); the non-exercise group received routine care. Transthoracic echocardiography (TTE) was used to assess cardiac structural parameters before discharge (T0) and after 12 weeks of exercise (T1). Functional outcomes including the 6-minute walk test (6MWT), Duke Activity Status Index (DASI), and Short Physical Performance Battery (SPPB) were compared between the two groups. A linear mixed-effects model was used to analyze the effect of home-based rehabilitation on echocardiographic parameters. Patients were stratified by baseline 6MWT (＜240 m as low-function subgroup, ≥240 m as high-function subgroup) to compare exercise-related outcomes between subgroups. Results At T1, the exercise group had a longer 6MWT distance than the non-exercise group (P＝0.012). The linear mixed-effects model showed that after 12 weeks of exercise, the left ventricular end-diastolic diameter (LVEDD) decreased in the exercise group but slightly increased in the non-exercise group, with a significant difference in changes over time between the two groups (P_interaction＝0.030). The exercise group also showed greater improvement in effective orifice area index (P_interaction＝0.028) and effective orifice area (P_interaction＝0.042) than the non-exercise group. Subgroup analysis revealed that in the low-function subgroup, the exercise group showed greater improvement in the 6MWT (P_interaction＝0.035) and the effective orifice area index (P_interaction＝0.046) compared to the non-exercise group; in the high-function subgroup, the exercise group showed greater improvement only in LVEDD compared to the non-exercise group (P_interaction＝0.046). Conclusions Home-based exercise rehabilitation improves exercise capacity, optimizes left ventricular remodeling, and enhances valvular function in patients with severe AS after TAVR, with greater benefits observed in patients with lower baseline 6MWT.

Objective To investigate the relationship between serum metalloproteinase-2(MMP-2),total antioxi-dant capacity(T-AOC),C-reactive protein(CRP),and recurrence in inguinal hernia(IH)patients with postoperative laparoscopic total extraperitoneal repair(TEP),as well as their predictive value.Methods A total of 122 IH pa-tients undergoing TEP in the First Affiliated Hospital of Xi'an Jiaotong University from January 2019 to De-cember 2022 were selected as the observation group,and 122 healthy subjects during the same period were se-lected as the control group.The patients were followed up for 10 months,and were divided into relapse group(n=37)and recovery group(n=85)according to their recurrence situation.Serum MMP-2 levels were detec-ted by automatic biochemical analyzer,T-AOC levels were determined by chemical colorimetric method,and CRP levels were assessed by enzyme-linked immunosorbent assay.The influencing factors of TEP recurrence in IH patients were analyzed by Logistic regression.The predictive value of serum MMP-2,T-AOC and CRP for postoperative TEP recurrence in IH patients was analyzed by receiver operating characteristic(ROC)curve.Results Serum MMP-2 and CRP levels in observation group were significantly higher than those in control group(P＜0.05),and T-AOC levels were significantly lower than those in control group(P＜0.05).MMP-2 and CRP in relapse group were significantly higher than those in recovery group(P＜0.05),and T-AOC level was lower than that in recovery group(P＜0.05).The area under the curve(AUC)of serum MMP2,T-AOC and CRP in pre-dicting TEP recurrence in IH patients were 0.775,0.804 and 0.731,respectively,and the AUC of the combined pre-diction of the three was 0.887,which was better than that of each indicator alone(Z=2.597,1.983,3.275,P=0.009,0.047,0.001).Conclusion Serum levels of MMP-2,T-AOC and CRP in IH patients with postoperative TEP recurrence significantly increase,which can be used as effective indicators to predict the postoperative TEP recurrence in IH patients,and the combined prediction efficiency of the three is higher.