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.

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.

This study was aimed at summarizing the epidemiological characteristics and spatial-temporal changes of hemorrhagic fever with renal syndrome(HFRS)in Hubei Province,China from 2005 to 2021,to provide scientific evi-dence for HFRS prevention and control.Data on individual HFRS cases and population information in Hubei Province from 2005 to 2021 were collected from the China Disease Pre-vention and Control Information System.The temporal,spa-tial,and demographic distribution characteristics of HFRS cases are described,and statistical methods such as medians,rates,and composition ratios were used for analysis.Joinpoint re-gression and Spearman's rank correlation were used to analyze the temporal trends in incidence rates or composition ratios.Global autocorrelation and hotspot analysis were conducted for spatial clustering analysis.Binary logistic regression was per-formed to analyze risk factors for HFRS mortality.A total of 5 790 HFRS cases were reported from 2005 to 2021,including 117 deaths.The average annual incidence rate was 0.57 per 100 000 population,and the case fatality rate was 2.02％.The overall incidence rate of HFRS in Hubei Province showed an increasing trend(AAPC=4.05％,95％CI:1.32％-6.78％),whereas the case fatality rate showed a decreasing trend over the years(r,=-0.72,P=0.002).HFRS exhibited a bimodal pattern,with peaks in the spring/summer months(May to July)and in the autumn/winter months(November to January of the following year).The incidence rate during the autumn/winter peak was slightly higher than that in the spring/summer peak.The incidence rate in males was higher than in females(RR=2.96,95％CI:2.79-3.14).The three age groups with the highest incidence rates were 60-64 years(747 cases,1.55 per 100 000),65-69 years(515 cases,1.39 per 100 000),and 55-59 years(762 cases,1.23 per 100 000).The incidence rate(2005:0.05 per 100 000;2021:0.08 per 100 000)and proportion(2005:2.69％;2021:1.94％)of HFRS cases in individuals 14 years or younger showed no significant trend over the years(AAPC=0.14％,95％CI:-0.03％-0.31％;AAPC=-3.64％,95％CI:-8.79％-1.50％).The incidence rate(2005:0.58 per 100 000;2021:1.59 per 100 000)and proportion(2005:14.80％;2021:44.31％)in the age group of 60 years or a-bove showed an increasing trend over the years(AAPC=10.52％,95％CI:4.38％-16.66％;AAPC=175.98％,95％CI:143.20％-208.75％).HFRS cases exhibited significant spatial clustering(P＜0.05).The hotspots of HFRS in Hubei Province shifted from the northern region(Xiangyang,Suizhou,Jingmen)in 2005-2007 to the southern region(Qianjiang,Xiantao,Tianmen,Jingzhou)in 2020-2021.Older age(OR=1.02,95％CI:1.01-1.04)and the period of 2005-2008 versus 2017-2021(OR=0.98,95％CI:0.97-0.99)were associated with relatively higher risk of HFRS mortality.In recent years,the HFRS epidemic in Hubei Province has continued to escalate,and areas such as Qianjiang City and other ares in the middle and lower reaches of the Yangtze River have experienced high incidence rates.The population 60 years of age or above is gradually becoming more susceptible to the disease.Targeted measures should be implemented to curb the rising trend of HFRS.

The breakage pattern of unit particles during the production of oral solid dosage forms (OSD) is closely related to the quality of intermediate or final products. To accurately characterize the particles and study the evolution law of particle breakage, the Bonding model of the discrete element method (DEM) was used to investigate the breakage patterns of model parameters, particle shape and process conditions (loading mode and loading rate) on the dynamic breakage, force-time curve, breakage rate, maximum breakage size ratio and fracture strength of particles. The results showed that the particle breakage force was positively correlated with normal strength and bonded disk scale, negatively correlated with normal stiffness per unit area and tangential stiffness per unit area, and weakly correlated with tangential strength. The particle breakage rate was negatively correlated with the aspect ratio of the particles, and the maximum breakage size ratio was positively correlated with the aspect ratio of the particles; among the three loading modes, the breakage rate of compression breakage model was the largest, the breakage rate of shear breakage model was the second largest, and the breakage rate of wear breakage model was the smallest; the maximum breakage size ratio was positively correlated with the loading rate, the loading mode and the loading rate had no mutual influence on particle breakage rate, but had mutual influence on the maximum breakage size ratio. The research results will provide a theoretical basis for the shift of OSD from batch manufacturing to advanced manufacturing.

【Objective】 To investigate the role of microRNA-218 (miR-218) in regulating prostate cancer (PCa) cell stemness and epithelial-mesenchymal transition (EMT). 【Methods】 PCa cell line stably overexpressing miR-218 was constructed with lentivirus transfection. The expression of miR-218 was detected with real-time fluorescence quantitative polymerase chain reaction (q-PCR). The migration ability was detected with Transwell assay. The expression of EMT related proteins were detected with Western blot. The properties of cells were determined with colony formation and tumor sphere formation assays. 【Results】 The results of q-PCR showed that the mRNA level of miR-218 was significantly lower in PCa cell lines LNCaP and C4-2 than in BPH-1. Transwell assay showed that miR-218 inhibited the migration of PCa cells. Western blot showed that the expression of EMT related proteins were inhibited by miR-218. Colony formation and tumor sphere formation assays showed that overexpression of miR-218 significantly inhibited the properties of cells. 【Conclusion】 The expression of miR-218 is downregulated in PCa cell lines. miR-28 can inhibit cell migration, EMT and cancer stem cell properties.

Objective:To explore the effect of health belief model in tumor patients with peripherally inserted central catheters (PICC) .Methods:From January 2020 to June 2021, 95 tumor patients admitted to the First Affiliated Hospital of Henan University of Chinese Medicine were selected by convenient sampling. The patients admitted from January to September 2020 were in the control group (47 cases), and the patients admitted from October 2020 to June 2021 were in the intervention group (48 cases). The control group was given routine catheter nursing, and the intervention group was given health belief model-based intervention.We compared the health cognition, compliance behavior and exercise behavior of the two groups of patients, and explored the transfer effect of compliance behavior and exercise behavior.Results:One month after the intervention, the health cognition, compliance behavior score and exercise behavior index in the intervention group were higher than those in the control group, with statistical differences ( P<0.05). There was a transfer effect from compliance behavior to exercise behavior. The non-normed fit index ( NNFI), comparative fit index ( CFI), goodness-of-fit index ( GFI) were all greater than 0.9, and root mean square error of approximation ( RMSEA) was less than 0.06. Conclusions:Health belief model-based intervention can improve the health knowledge and rehabilitation exercise behavior of tumor patients with PICC. Compliance behavior has a transfer effect on exercise behavior, which can achieve the dual effect of promoting the change of health behavior.

The quality difference of pharmaceutical excipients from different sources affects the molding properties of the powder, resulting in changes in the properties of the final product. In this study, the critical quality attributes of hydroxypropyl methylcellulose (HPMC) with different specifications from two manufacturers (manufacturer A and manufacturer B) were characterized including particle size, physical morphology, viscosity and powder physical quality attributes. Aminophylline, diclofenac sodium, and metformin hydrochloride were utilized as model drugs with different solubility to prepare sustained-release tablets, and the effect of HPMC from different sources on drug release of sustained-release tablets in vitro was investigated. The results showed that HPMC with the same viscosity specification from different sources had outstanding differences in the physicochemical properties (including particle size, physical morphology, viscosity, dimension, compressibility and powder flow), which could change the hardness and friability of the sustained-release tablets. The differences in the physicochemical properties of HPMC had different effects on the dissolution of different sustained-release tablets in vitro. It had no significant effect on the release of easily soluble aminophylline and metformin hydrochloride, but had a greater impact on the release of poorly soluble diclofenac sodium. Compared with manufacturer A, the sustained-release effect of matrix tablets prepared by HPMC from manufacturer B was more excellent. The results of this study will provide a theoretical reference on selecting the appropriate excipients for formulation design.

Objective:To analyze clinicopathological characteristics of trauma-related melanoma and their relationship with the prognosis of patients.Methods:Clinical data were collected from 87 cases of trauma-related melanomas in Department of Dermatology, Xijing Hospital, the Fourth Military Medical University from 2009 to 2020, and their clinicopathological characteristics were retrospectively analyzed. Mann-Whitney test was used to analyze the difference in Breslow thickness of tumors between patients of different ages or genders; Spearman rank correlation analysis was used to analyze the correlation between the time from trauma to the notice of melanoma and Breslow thickness, Kaplan-Meier survival analysis and Log-Rank test were employed to analyze the relationship between clinicopathological characteristics of melanoma and the prognosis of patients; Cox regression model was used to analyze risk factors for survival duration of patients with trauma-related melanoma.Results:Among the 87 patients with trauma-related melanoma, 47 (54.02%) were males and 40 (45.98%) were females. Among them, melanoma occurred in 50 (57.47%) cases after sharp injuries, and in 37 (42.53%) after blunt injuries. In addition, 31 (35.63%) cases presented with primary lesions on the hands, and 48 (55.17%) on the feet. The Breslow thickness of the primary tumors was significantly higher in the group aged > 55 years than in the group aged ≤ 55 years ( U= 623.500, P= 0.010) , but there was no significant difference between patients of different genders ( P= 0.138) . The time from trauma to the notice of melanoma was negatively correlated with the Breslow thickness of tumors ( r=-0.203, P= 0.037) . The age of patients, Breslow thickness of tumors, Ki67 proliferation index and genetic background of tumor significantly affect the survival duration of patients with trauma-related melanoma ( P= 0.011, 0.031, 0.002 and 0.031, respectively) ; the gender, type of trauma and ulceration of tumor mass did not significantly affect the survival duration of patients ( P= 0.618, 0.114 and 0.379, respectively) . Cox regression model analysis showed that the Ki67 proliferation index and Breslow thickness were independent risk factors affecting the prognosis of trauma-related melanoma (risk ratio [ RR] and 95% confidence interval [ CI] were 1.946 (1.234, 4.217) and 1.839 (1.014, 3.332) , P= 0.039 and 0.045, respectively) . Conclusion:The Breslow thickness of trauma-related melanoma is related to the age of patients and time from trauma to the notice of melanoma; the age, Breslow thickness of tumors, Ki67 proliferation index and genetic background of tumor all affect the survival duration of patients with melanoma, and Ki67 proliferation index and Breslow thickness are independent risk factors affecting prognosis.

Objective To investigate the correlation and expression of PTEN, matrix metalloproteinase-9 (MMP-9),and vascular endothelial growth factor-C(VEGF-C)in colorectal cancer.Methods The expression of PTEN, MMP-9 and VEGF-C in 102 cases of colorectal cancer tissues and 30 cases of normal colorectal tissues was detected using immunohistochemical SP method.Their correlations with cliniopathologic features were analyzed. Results The positive expression of PTEN in colorectal cancer was significantly lower than that in the controls (54.9%vs 100%, P<0.01).Both MMP-9 and VEGF-C were over expressed compared with the controls(83.3%vs 21.7%and 69.6%vs 16.7%respectively, P<0.01).The expression of PTEN was negatively correlated with that of MMP-9 and VEGF-C, and the expression of MMP-9 was positively correlated with that of VEGF-C ( P<0.05).The expressions of the three proteins in colorectal cancer tissues were not associated with age, gender, or tumor size.There were significant associations between the expression of these proteins and lymph node metastasis, distant metastasis, differentiation, and TNM staging(P<0.05).The 1, 3 and 5-year survival rates of the patients with positive PTEN were significantly higher than those of the patients with negative PTEN(P<0.05).The 1, 3 and 5-year survival rates of the patients with positive MMP-9 and VEGF-C were significantly lower than those of the patients with negative MMP-9 and VEGF-C( P<0.05) .Conclusions The decrease in the expression of PTEN and increase in MMP-9 and VEGF-C are closely correlated to the development of colorectal cancer.Their expressions may be favorable markers and useful prognostic indicators in the patients with colorectal cancer.

Objective To understand the relation between smoking and serum uric acid level and to investigate whether the ser-um uric acid has the correlation with the gender,age and smoking history.Methods The data of the gender,age,blood uric acid in1 847 individuals aged 20-80 years with the healthy physical examination and without underlying diseases were performed the statisti-cal analysis.Results With male and female as the research objects,the serum uric acid level of smokers were higher than that of non-smokers and occasional smokers,the difference was statistically significant;the serum uric acid level had no statistically signifi-cant difference between smokers and occasional smokers;the serum uric acid level had no statistically significant difference among non-smoking,occasional smoking and smoking groups for males as the research objects alone;to divide the male subjects into groups according to age,the serum uric acid level of non-smokers,occasional smokers and smokers were not statistically significant among all age groups;serum uric acid level showed the increasing trend with the increase of smoking history,but there was no statistically significant difference.Conclusion The serum uric acid level of smokers is significantly higher than that of non-smokers and occa-sional smokers with male and female as the research objects;the difference in serum uric acid level between smokers and occasional smokers has no statistical significance;excluding the gender factor interference,the serum uric acid level of males is not affected by smoking or age;serum uric acid mean value demonstrates the increasing trend with the increase of smoking history.