For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Subject recruitment is a key component that affects the progress and results of clinical trials, and generally conducted with eligibility criteria (includes inclusion criteria and exclusion criteria). The semantic category analysis of eligibility criteria can help optimizing clinical trials design and building automated patient recruitment system. This study explored the automatic semantic categories classification of Chinese eligibility criteria based on artificial intelligence by academic shared task. We totally collected 38 341 annotated eligibility criteria sentences and predefined 44 semantic categories. A total of 75 teams participated in competition, with 27 teams having submitted system outputs. Based on the results, we found out that most teams adopted mixed models. The mainstream resolution was applying pre-trained language models capable of providing rich semantic representation, which were combined with neural network models and used to fine-tune the models with reference to classifier tasks, and finally improved classification performance could be obtained by ensemble modeling. The best-performing system achieved a macro
Artificial Intelligence ; China ; Humans ; Language ; Natural Language Processing ; Neural Networks, Computer

Objective To investigate the effects of exosomes derived from human dental pulp mes-enchymal stem cells ( hDPSC-exosomes) on the maturation and function of dendritic cells ( DC) stimulated by lipopolysaccharide ( LPS ) , and to evaluate their regulatory effects on the immune system. Methods Adult permanent teeth-derived dental pulp mesenchymal stem cells were cultured in vitro to extract exosomes in the cell culture medium. The morphology and sizes of the exosomes were observed under transmission electron microscopy. Expression of CD9 and CD63 on the surface of the exosomes was detected by Western blot. PBS, LPS and LPS+hDPSC-exosomes were respectively used to stimulate mouse bone marrow-derived dendritic cells (DC2. 4) for 24 h. A blank control group was set up accordingly. Expression of co-stimulato-ry molecules and cytokine secretion were detected by flow cytometry and ELISA, respectively. Expression of TLR2, TLR4 and NF-κB at mRNA level was detected by RT-PCR. Changes in the functions of DC were evaluated by mixed lymphocyte reaction ( MLR) . Results Adult permanent teeth-derived dental pulp mes-enchymal stem cells were successfully isolated. Up-regulated CD73 and CD90, and down-regulated CD45 were detected on the surface of the cells. Under electron microscopy ( SEM ) , hDPSC-exosomes showed round or oval microcapsule bodies about 50-80 nm in diameter with positive surface markers of CD9 and CD63. hDPSCs-exosomes could significantly reduce the LPS-induced expression of co-stimulatory molecules CD11c and CD86 on DC surface. Moreover, hDPSCs-exosomes increased TGF-β expression and decreased IL-4. They could also significantly inhibit the proliferation of splenic lymphocytes that was induced by DC af-ter LPS stimulation. Compared with the blank control group, hDPSC-exosomes could promote the expression of TLR2 and TLR4 on DC surface and up-regulate the expression of NF-κB. Conclusions This study showed that hDPSC-exosomes could inhibit the activation and functional maturation of DC, promote the de-velopment towards tolerant DC through TLR-NF-κB signaling pathway, and induce immune tolerance to regu-late immune balance.