Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To analyze the clinicopathological characteristics and prognostic factors of patients with Castleman disease (CD).Methods:A retrospective case-series study was conducted. A total of 85 patients newly diagnosed with CD in the First Affiliated Hospital of Air Force Medical University between July 2007 and August 2024 were collected. Their clinical characteristics and prognostic factors were analyzed.Results:Among the 85 patients, 45 had unicentric Castleman disease (UCD) and 40 had multicentric Castleman disease (MCD). In the UCD group, females were more commonly affected (64.4%, 29/45), with a median age of onset of 39 years. The primary lesions were mainly located in the retroperitoneum, neck, abdomen, and axilla; and the hyaline vascular subtype was the predominant pathological type (69.4%, 25/36). In the MCD group, males were more frequently affected (62.5%, 25/40), with a median age of onset of 50 years; and the plasmacytic subtype was the main pathological type (68.2%, 15/22). Compared with UCD patients, MCD patients presented more systemic symptoms and signs [85.0% (34/40) vs. 13.3% (6/45), χ2 = 43.66, P < 0.001], splenomegaly [42.5% (17/40) vs. 2.2% (1/45), χ2 = 20.58, P < 0.001], hepatomegaly [25.0% (10/40) vs. 0 (0/45), χ2 = 10.46, P = 0.001], edema or effusion in serous cavity [67.5% (27/40) vs. 8.9%(4/45), χ2 = 31.40, P < 0.001], hematological system involvement [32.5% (13/40) vs. 0 (0/44), χ2 = 16.92, P < 0.001], and renal involvement [22.5% (9/40) vs. 2.3%(1/44), χ2 = 6.36, P = 0.012]. Laboratory findings showed that the levels of hemoglobin and albumin in MCD patients were lower than those in UCD patients, while white blood cell count in MCD patients was higher than that in UCD patients. Additionally, MCD patients exhibited elevated levels of C-reactive protein, interleukin-6, vascular endothelial growth factor, erythrocyte sedimentation rate, and ferritin compared to UCD patients (all P < 0.05). Among UCD patients, 40 cases underwent simple surgical resection, with no deaths during follow-up and the 5-year overall survival (OS) rate of 100.0%; among MCD patients, 34 cases received chemotherapy, 4 received siltuximab, 3 died during follow-up with a 5-year OS rate of 87.5%; and there was no statistically significant difference in OS between the MCD and UCD groups ( χ2 = 3.67, P = 0.055). Among MCD patients, the OS of those with renal involvement (9 cases) was worse than that of those without renal involvement (31 cases) ( χ2 = 8.39, P = 0.004). Conclusions:CD is a highly heterogeneous disorder. Surgical resection is the primary treatment for UCD, with a favorable prognosis. Chemotherapy is the main treatment for MCD, with a relatively poor prognosis.

ObjectiveTo evaluate the effects of Wuhua herbal tea on chronic unpredictable mild stress (CUMS)-induced depression and explore its mechanism of action in combating depression.MethodsWe tested the antidepressant effects of Wuhua herbal tea in a rat model of CUMS-induced depression using fluoxetine as a positive control. The rats were divided into four groups: control group, model group, fluoxetine group, and Wuhua herbal tea group. The rats underwent body weight measurements, sucrose preference test, and open-field test. Enzyme-linked immunosorbent assay kits were used to detect the serum levels of serotonin, dopamine, adrenocorticotropic hormone (ACTH), corticosterone, norepinephrine, and interleukin-6. Intergroup comparisons and detection of brain-derived neurotrophic factor (BDNF), cAMP-response element binding protein (CREB), Janus kinase 2 (JAK2), and signal transducer and activator of transcription 3 (STAT3) mRNA expression in the hippocampus were performed using RT-PCR. Immunohistochemistry was used to identify the expression of phosphorylated JAK2 (p-JAK2) and phosphorylated STAT3 (p-STAT3) proteins in hippocampal paraffin sections of CUMS rats.ResultsCompared with the control group, the model group rats had depressive tendencies, exhibiting low vitality and interest in various behavioral indicators which were signs of despair. The Wuhua herbal tea group statistically increased the levels of serotonin and dopamine in the serum of CUMS rats to varying degrees (P = .015 and P = .002); reduced serum levels of ACTH, corticosterone, norepinephrine, and interleukin-6 (all P .05); and decreased mRNA expression of BDNF, CREB, JAK2, and STAT3 in the hippocampus (all P .05); and decreased p-STAT3 protein levels (P = .006).ConclusionWuhua herbal tea shows antidepressant potential in CUMS rats by modulating the HPA axis and inhibiting JAK2-STAT3 overactivation, alleviating neuroinflammation. It also restores BDNF-CREB pathway function, reducing depressive symptoms.

Objective To explore the predictive value of troponin Ⅰ(TnⅠ)peak value upon admission for predicting left ventricular ejection fraction(LVEF)＜50％in patients with acute myocardial infarction(AMI)during the recovery period.Methods A retrospec-tive analysis was carried out on 220 AMI patients admitted to Beijing Friendship Hospital from 2018 to the present.The patients were di-vided into three groups based on the peak value of TnⅠ during their stay in hospital,and the baseline data were compared.Subsequently,three progressively complex regression models were constructed to evaluate the relationship between TnⅠ and LVEF＜50％.The optimal cutoff value was determined through restricted cubic spline and smooth curve analysis.Additionally,subgroup analysis was carried out to explore differences in the predictive value of TnⅠ in different populations.Results TnⅠ peak value was significantly associated(P＜0.05)with the ratio of emergency percutaneous coronary intervention(PCI),neutrophil-to-lymphocyte ratio,white blood cell count,neutro-phils,intra-aortic balloon pump usage,N-terminal pro-brain natriuretic peptide peak value,and so on.All three models showed a sig-nificant increase in the risk of LVEF＜50％with higher TnⅠ peak value(P＜0.05).Restricted cubic spline and smooth curve analysis re-vealed a linear relationship between TnⅠ peak value and LVEF values,with the optimal cutoff value for TnⅠ peak value consistently at 29.80ng/ml across the three models.Subgroup analysis showed that the predictive value of peak TnⅠ for LVEF＜50％demonstrated statisti-cally significant differences across the following subgroups:male patients,those with high BMI,hypertension,acute interventional treat-ment,as well as different age groups,and whether patients had diabetes,smoked,or consumed alcohol.Conclusion An admission TnⅠpeak value exceeding 29.80ng/ml is an independent risk factor for predicting LVEF＜50％during the recovery period in AMI patients.It can be used to identify high-risk individuals and provide a basis for early aggressive intervention.

Objective To investigate the relationship between the peak levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP)during hospitalization and the risk of left ventricular ejection fraction(LVEF)＜50％during the recovery period in pa-tients with acute myocardial infarction(AMI).Methods This retrospective cohort study included 220 AMI patients treated at Beijing Friendship Hospital,Capital Medical University from January 2018 to December 2023.The patients were divided into three groups accord-ing to the tripartite value of peak levels of NT-proBNP during hospitalization.Baseline clinical characteristics,laboratory test results,and peak levels of NT-proBNP were collected.The primary outcome was LVEF＜50％during the recovery period.By incorporating con-founding factors,three stepwise complex Logistic regression model and linear regression model were used to analyze the relationship be-tween peak levels of NT-proBNP and the risk of LVEF＜50％.Restricted cubic spline(RCS)was used to explore the nonlinear relation-ship between them.Results The peak levels of NT-proBNP were positively correlated with an increased risk of LVEF＜50％during the recovery period,even after adjusting for confounding factors.RCS analysis revealed the nonlinear relationships between them.When the peak levels of NT-proBNP was 1822.991pg/ml,the sensitivity and specificity of predicting LVEF＜50％were 57.14％and 70.97％.Conclusion The NT-proBNP peak levels of 1822.991 pg/ml is a useful indicator for predicting LVEF＜50％in AMI pa-tients during the recovery period,and it can be used to identify high-risk AMI groups and provide basis for early active intervention.

Objective To explore the predictive value of troponin Ⅰ(TnⅠ)peak value upon admission for predicting left ventricular ejection fraction(LVEF)＜50％in patients with acute myocardial infarction(AMI)during the recovery period.Methods A retrospec-tive analysis was carried out on 220 AMI patients admitted to Beijing Friendship Hospital from 2018 to the present.The patients were di-vided into three groups based on the peak value of TnⅠ during their stay in hospital,and the baseline data were compared.Subsequently,three progressively complex regression models were constructed to evaluate the relationship between TnⅠ and LVEF＜50％.The optimal cutoff value was determined through restricted cubic spline and smooth curve analysis.Additionally,subgroup analysis was carried out to explore differences in the predictive value of TnⅠ in different populations.Results TnⅠ peak value was significantly associated(P＜0.05)with the ratio of emergency percutaneous coronary intervention(PCI),neutrophil-to-lymphocyte ratio,white blood cell count,neutro-phils,intra-aortic balloon pump usage,N-terminal pro-brain natriuretic peptide peak value,and so on.All three models showed a sig-nificant increase in the risk of LVEF＜50％with higher TnⅠ peak value(P＜0.05).Restricted cubic spline and smooth curve analysis re-vealed a linear relationship between TnⅠ peak value and LVEF values,with the optimal cutoff value for TnⅠ peak value consistently at 29.80ng/ml across the three models.Subgroup analysis showed that the predictive value of peak TnⅠ for LVEF＜50％demonstrated statisti-cally significant differences across the following subgroups:male patients,those with high BMI,hypertension,acute interventional treat-ment,as well as different age groups,and whether patients had diabetes,smoked,or consumed alcohol.Conclusion An admission TnⅠpeak value exceeding 29.80ng/ml is an independent risk factor for predicting LVEF＜50％during the recovery period in AMI patients.It can be used to identify high-risk individuals and provide a basis for early aggressive intervention.

Objective To investigate the relationship between the peak levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP)during hospitalization and the risk of left ventricular ejection fraction(LVEF)＜50％during the recovery period in pa-tients with acute myocardial infarction(AMI).Methods This retrospective cohort study included 220 AMI patients treated at Beijing Friendship Hospital,Capital Medical University from January 2018 to December 2023.The patients were divided into three groups accord-ing to the tripartite value of peak levels of NT-proBNP during hospitalization.Baseline clinical characteristics,laboratory test results,and peak levels of NT-proBNP were collected.The primary outcome was LVEF＜50％during the recovery period.By incorporating con-founding factors,three stepwise complex Logistic regression model and linear regression model were used to analyze the relationship be-tween peak levels of NT-proBNP and the risk of LVEF＜50％.Restricted cubic spline(RCS)was used to explore the nonlinear relation-ship between them.Results The peak levels of NT-proBNP were positively correlated with an increased risk of LVEF＜50％during the recovery period,even after adjusting for confounding factors.RCS analysis revealed the nonlinear relationships between them.When the peak levels of NT-proBNP was 1822.991pg/ml,the sensitivity and specificity of predicting LVEF＜50％were 57.14％and 70.97％.Conclusion The NT-proBNP peak levels of 1822.991 pg/ml is a useful indicator for predicting LVEF＜50％in AMI pa-tients during the recovery period,and it can be used to identify high-risk AMI groups and provide basis for early active intervention.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To investigate the effectiveness and safety of balloon dilation technique when difficult ureteroscope accessing in ureteroscopic holmium laser lithotripsy in children.Methods Clinical data of 23 patients(25 sides)receiving ureteroscopic holmium laser lithotripsy with using balloon dilatation technique from March 2020 to October 2023 were retrospectively analyzed.When it was difficult to insert ureteroscope,the ureteral balloon catheter was retrogradely inserted through the ureteroscopic working channel to dilate the narrow part of the ureteral lumen.After dilation,the holmium laser fiber was inserted to powder the stones.Results Of the 23 patients(25 sides)with ureteral calculi,transcatheter ureteral balloon dilation was carried out in 26 places during the operation,including 23 places located in the inner part of the ureteral bladder wall and 3 places located in the lower part of the ureter.The extent of ureteral injury at dilated sites was grade Ⅰ in 23 places and grade Ⅱ in 3 places,respectively.After ureteral balloon dilatation,continued lithotripsy succeeded on 23 sides and failed on 2 sides.No complications related to ureteral dilated balloon catheter were found.The time for removing double-J ureteral stents was 26-45 d(mean,33.5±5.2 d),during which urinary tract infection occurred in 5 cases.Urinary system ultrasound examination was performed within 2 weeks after removal of double-J ureteral stents.The calculi were discharged in all the children,without hydronephrosis.No ureteral stenosis was observed in all the children during 6-24 months(mean,13.7 months)of postoperative follow-ups.Conclusion It is safe and effective to dilate the ureteral with balloon dilation technique through the working channel when difficult ureteroscope accessing.

The aim of this experiment was to investigate the effects of Chinese angelica polysaccha-ride(CAP)on peritoneal macrophage function before and after selenization.In the experiment,CAP and selenized Chinese angelica polysaccharide(sCAP)were applied to mouse peritoneal mac-rophages,and the phagocytic activity of macrophages as well as the expression of the cellular phe-notypes F4/80,MHC-Ⅱ,CD80 and CD86 were detected by flow cytometry,and the changes of IL-6,IL-10,NO,MIP-1α,and TNF-α content in the supernatant of macrophage were detected by ELISA.The results showed that the phagocytic activity of peritoneal macrophages was significantly higher in the sCAP mass concentration of 1.96 mg/L than in the other groups(P＜0.05);and the expression of F4/80,MHC-Ⅱ,CD80 and CD86 were significantly higher in the sCAP mass concen-tration of 1.96 mg/L than in the CAP group and cell control group(P＜0.05);the contents of IL-6,IL-10,NO,and MIP-1α in the supernatant of macrophages were significantly higher than those in other groups when the mass concentration of sCAP ranged from 7.81 to 1.96 mg/L(P＜0.05).The results showed that sCAP had an enhancing effect on the immunomodulatory function of ab-dominal macrophages and was optimal at a mass concentration of 1.96 mg/L.