Objective:To evaluate the perioperative application effect of enhanced recovery after surgery (ERAS) clinical pathway in percutaneous vertebro plasty (PVP).Methods:The clinical data of 274 patients who underwent PVP treatment for osteoporotic vertebral compression fracture (OVCF) in Beijing Friendship Hospital, Capital Medical University from May 2023 to August 2024 were retrospectively analyzed. The patients were divided into two groups according to the different numbers of surgical segments: the single-segment group ( n=211) and the multisegment group ( n=63). Patients in the single-segment group underwent single-segment surgery, while patients in the multisegment group underwent surgery on ≥2 segments. The core points of the ERAS clinical pathway adopted in this study include perioperative education, pain management, early mobilization, application of "outfast", and joint guidance from the departments of nutrition and rehabilitation. Comparison was made between the two groups of patients in terms of visual analog scale (VAS) scores for low back pain at preoperative, 2 h, 6 h, 24 h postoperatively, and on the day of discharge; Oswestry disability index (ODI) scores preoperatively and on the day of discharge; time to first ambulation postoperatively, total length of hospital stay, postoperative length of stay, perioperative complications, and perioperative application of Opioid consumption. Measurement data were expressed as mean±standard deviation ( ± s), and the independent sample t-test was used for comparison between groups; count data were expressed as cases and percentage, and the Chi-square test was used for comparison between groups. The VAS pain scores at each stage of the perioperative period were evaluated using repeated measures analysis of variance or generalized estimating equations. Results:Compared with that before the operation [(6.17±0.93) points, (6.29±0.83) points], the VAS scores of low back pain of patients in the single-segment group and the multisegment group at 2 hours after surgery [(3.09±0.82) points, (3.27±0.65) points], 6 hours after surgery [(2.60±0.79) points, (2.62±0.55) points], and 24 hours after surgery [(1.89±0.77) points, (1.97±0.72) points] and on the day of discharge [(1.72±0.71) points, (1.81±0.64) points] were significantly decreased, and the differences were statistically significant ( P<0.05). At the same stage, the VAS scores of low back pain in both groups were not statistically significant ( P>0.05). The ODI scores of patients in the single-segment group and the multisegment group on the day of discharge [(24.21±2.35) points, (24.63±3.31) points] were significantly lower than those before the operation [(64.50±4.81) points, (65.52±4.08) points], and the differences were statistically significant ( P<0.05). There were no statistically significant differences in perioperative complications and the proportion of Opioid drug application between the two groups of patients ( P>0.05). Conclusion:For patients with single-segment or multisegment OVCF, PVP surgical treatment under ERAS clinical pathway management can achieve immediate pain relief, early ambulation exercise, and satisfactory perioperative efficacy.

Objective:To evaluate preoperative malnutrition risk in patients with osteoporotic vertebral compression fracture (OVCF) based on mini nutritional assessment short form (MNA-SF) and analyze the related clinical risk factors.Methods:A cross-sectional study was conducted using clinical data from 129 OVCF patients who underwent percutaneous vertebroplasty at Beijing Friendship Hospital, Capital Medical University, between May 2023 and December 2023. The cohort included 26 males and 103 females, aged (74.71±9.13) years(ranging from 48-98 years). According to MNA-SF scoring method, they were divided into three groups, the malnutrition group ( n=6), the nutritional risk group ( n=40), and the good nutrition group ( n=83). Nutritional risk and malnutrition rates were evaluated using the MNA-SF score. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s) and compared using one-way ANOVA. The comparison between groups of count data was conducted using chi-square test. Univariate analysis and multivariate logistic regression were performed to identify independent risk factors for malnutrition and nutritional risk. Results:According to the MNA-SF score, among 129 patients, the malnutrition rate was 4.7%, the nutritional risk rate was 31.0%, and 64.3% exhibited adequate nutrition based on MNA-SF scores. The results of one-way ANOVA showed that gender ( P=0.023) and BMI ( P<0.001) were significantly correlated with malnutrition and nutritional risk; Logistic regression analysis suggested that the influencing factors of nutritional risk included gender ( P=0.002) and BMI ( P<0.001), while the only dangerous factor of malnutrition was BMI ( P<0.001). Conclusions:Bsed on MNA-SF, OVCF patients undergoing percutaneous vertebroplasty have a higher incidence of malnutrition and nutritional risk. The risk factors for nutritional risk in patients are gender and BMI, while the risk factor for malnutrition is only BMI.

Objective:To evaluate the reliability and validity of the Chinese version of HEMO-FISS-QoL(HF-QoL) questionnaire (HF-QoL-C) in the Chinese population with hemorrhoids.Methods:From November 2021 to November 2022, a self-constructed general information questionnaire, HF-QoL-C, and the 36-item short form health survey (SF-36), Goligher classification, and Giordano severity of hemorrhoid symptom questionnaire (GSQ) were used to conduct a questionnaire survey on 760 hemorrhoid patients in the anorectal department of six hospitals. The data was analyzed for reliability and validity using SPSS 21.0 and AMOS 26.0 software.Results:The Cronbach's α coefficient of HF-QoL-C and its dimension ranged from 0.831 to 0.960, and the split coefficient was 0.832-0.915. Four common factors were extracted through principal component exploratory factor analysis. Confirmatory factor analysis indicated acceptable structural validity( χ2/ df=8.152, RSMEA=0.097, CFI=0.881, IFI=0.881, NFI=0.867). HF-QoL-C was correlated with SF36 and GSQ( r=-0.694, 0.501, both P<0.01). There were differences in the total score and dimensional scores of HF-QoL-C between surgical and drug treated patients, different grades of Goligher classification for hemorrhoidal disease, and different ranges of hemorrhoid prolapse (all P<0.001). No ceiling effect was found in the total score and the scores of each dimension(0.3%-2.0%). There was a floor effect in both psychological function and sexual activity dimensions (16.7%, 35.1%). Conclusion:HF-QoL-C has good reliability and validity, which can be used to measure the quality of life of Chinese hemorrhoid patients.

Objective:To explore the impact of different preoperative fluid supplementation methods (oral multidimensional carbohydrates and conventional fluid supplementation) on early postoperative recovery and pain management in patients undergoing unilateral biportal endoscopic (UBE) spine surgery.Methods:A retrospective cohort study was conducted to analyze the data of 386 patients who underwent UBE lumbar spine surgery under general anesthesia in the two courtyards of Beijing Friendship Hospital Affiliated to Capital Medical University from May 2023 to April 2024. All patients were divided into oral multidimensional carbohydrates ( "Outfast" supplementation, composed mainly of water, sugars, salts, and vitamins) group (referred to as oral "Outfast" group, 189 patients) and conventional fluid supplementation group (197 patients) according to the type of fluid replenishment. Patients in the oral "Outfast" group were given one oral dose in the morning of the first surgery, and another oral infusion before 10∶00 in the morning of the next surgery or afternoon surgery. Patients in the conventional fluid supplementation group received intravenous infusion in the morning of the first surgery, and were given intravenous infusion of glucose and sodium chloride injection in the morning of the next surgery or afternoon surgery. The two groups were compared for the proportion of patients receiving preoperative intravenous fluids on the day of surgery, intraoperative and postoperative fluid volumes, average daily fluid volumes over the first three postoperative days, time to first postoperative ambulation, time to first bowel movement, post-anesthesia care unit (PACU) stay duration, 4-hour and 24-hour postoperative visual analog scale (VAS) pain scores, incidence of anesthesia-related adverse reactions, and incidence of severe gastrointestinal adverse reactions. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for inter-group comparison. The measurement data of skewed distribution were expressed as M ( Q1, Q3) and rank sum test was used for inter-group comparison. Count data was presented in terms of examples and percentages, and a chi-square test was used for comparison between two groups. Results:In the oral "Outfast" group, 8 patients (4.2%) received preoperative intravenous fluids on the day of surgery, compared to 136 patients (69.0%) in the conventional fluid supplementation group, showing a significant difference ( P<0.001). The postoperative fluid volumes, average daily fluid volumes over the first three postoperative days, and shorter time to first ambulation in the oral multidimensional carbohydrates group were 700.0(600.0, 1 100.0) mL, 200.0(200.0, 300.0) mL, and 6.0(6.0, 11.0) h, respectively. The conventional fluid supplementation group was 1 100.0(700.0, 1 200.0) mL, 600.0(500.0, 700.0) mL, and 12.0(6.0, 19.0) h, respectively. The oral "Outfast" group was lower than the conventional fluid supplementation group ( P<0.001).There were no significant differences between the two groups in intraoperative fluid volumes, time to first bowel movement, PACU stay duration, 4-hour and 24-hour VAS pain scores, incidence of anesthesia-related adverse reactions, or incidence of severe gastrointestinal adverse reactions ( P>0.05). Conclusions:Preoperative oral multidimensional carbohydrates supplementation effectively reduces the amount of preoperative and postoperative intravenous fluid required, shortens the time to first ambulation. Preoperative oral multidimensional carbohydrates is safe and does not adversely impact gastrointestinal reactions or pain management in the postoperative period.

The experience of famous and veteran physicians in traditional Chinese medicine （TCM） is a supplement to the cognition of industry groups and a high-quality learning resource. Digital inheritance of the experience of famous and veteran TCM physicians refers to the use of digital technology to record， organize， protect， spread， share and innovate the knowledge， skills and experiences of famous and veteran TCM physicians， which helps to overcome the inefficiency of traditional experience inheritance and realize the inheritance and development of TCM culture. Digital inheritance has certain advantages in accessibility， loss resistance， accuracy， innovation ability and effectiveness， which can assist the digital preservation， analysis and excavation of the experience of famous and veteran TCM physicians， and is an important supplement to the traditional way of learning from teachers. Digital inheritance is usually divided into the following steps： building a database of TCM knowledge， building a database of experienced medical records of famous and veteran TCM physicians， discovering laws by data mining， and assisting clinical decision-making with machine learning. The digital inheritance of famous and veteran TCM physicians is not only the use of experience information， but also the process of innovation and productization based on experience， which may become a new service model of TCM diagnosis and treatment.

By reviewing ancient materia medica， medical books， prescription books and modern literature， the herbal textual research of Sanguisorbae Radix has been conducted to verify the name， origin， evolution of scientific name， producing area， harvesting time， quality evaluation and processing methods. Through herbal textual research， the name of Diyu was first published in the Shennong Bencaojing， and has been used as the proper name of this herb for generations since then. The origin of the mainstream Diyu of previous generations was the roots of Sanguisorba officinalis or its variant S. officinalis var. longifolia. In ancient times， this herb was preferred to those with soft and fat roots， according to this characteristic， its origin should be S. officinalis var. longifolia. In modern literature， the root is preferred to those with thick， hard， pink or red sections， without rhizomes or fibrous roots， according to these characteristics， its origin should be S. officinalis. Most of the time， the past generation used Diyu directly. Occasionally， Sanguisorbae Radix was processed by frying with vinegar， baking or other methods. Since the Qing dynasty， the carbonized products has appeared and has continued to now. Based on research， it is recommended that the roots of S. officinalis var. longifolia should be used in the development of famous classical formulas， and the processing method should be selected according to the formula.

By reviewing ancient materia medica and combining with modern literature， the textual research of Magnoliae Flos has been conducted to verify the name， origin， producing area， harvesting and processing methods， in order to provide basis for the selection and use of this herb in the development of famous classical formulas. After the textual research， it could be seen that the correct name of Magnoliae Flos was Xinyi in the past dynasties， meaning spicy flower buds. The main original plants used in past dynasties are Magnolia denudata and M. biondii. The history of the research on its scientific name in recent times is complicated， many foreign scholars have given several different scientific names， but most of them are inconsistent with the actual situation of Magnoliae Flos used in ancient China， because foreign scholars failed to collect the original plants of Magnoliae Flos for accurate identification. Before the Ming dynasty， Magnoliae Flos was mainly produced in Shaanxi， and then the recorded production areas gradually increased. After the founding of the People's Republic of China， the products produced in Henan named M. biondii were highly respected， and Henan was regarded as authentic producing area， and because of the collection and distribution through Yuzhou， it was customarily called Huichunhua. In ancient times， the harvesting period of Magnoliae Flos mostly concentrated in the first and second months of the lunar calendar， and the flower buds of M. biondii were also recommended to be used as medicine， but nowadays the flower buds are mostly collected in winter and spring， and those with dry buds， large size， yellow-green color， tight inner petals， fragrant smell， and no impurities are preferred. In the past dynasties， raw products were the mainstream， and there were also frying， soaking and so on. Based on the results， it is suggested that the flower buds of M. biondii should be used in the development of famous classical formulas. If the original formula does not specify the processing requirements， the raw products can be used as medicine.

Objective To investigate the relationship between CD4+CD28na cells,oxidative stress markers malondialdehyde(MDA) and superoxide dismutase(SOD) and the pathogenesis of polycystic ovary syndrome(PCOS).Methods Thirty-two patients with PCOS(PCOS group) and 28 healthy women(control group) were selected.Six ml of peripheral venous blood were taken from each person,3 ml of which were separated and serum was collected.Sex hormone level,C-reactive protein (CRP),SOD and MDA were detected.Peripheral blood mononuclear cells (PBMCs) were isolated from the other 3 ml blood by centrifugation,and CD4+CD28null T cell subsets were detected by flow cytometry.The characteristics of each detected index of PCOS patients and healthy controls were compared.Results The proportion of CD4+CD28null T cells in the peripheral blood of the PCOS group was significantly higher than that of the control group (P＜0.05).The serum CRP and MDA in PCOS group were both significantly higher than that in the control group,and SOD was significantly lower than the control group(P＜0.05).Correlation analysis showed that the expression of CD4+CD28null T cells in the PCOS group was positively correlated with CRP(P＜0.05) and MDA(P＜0.05) and negatively correlated with SOD (P＜0.05).Conclusions Our study shows a disorder of immunoregulatory mechanism represented by abnormal increase of CD4+CD28null T cell expression and an imbalance of oxidative stress in patients with PCOS.The further study of relationship between these two pathophysiological patterns and PCOS may help to elucidate its pathogenesis.

CCCTC-binding factor (CTCF) is a zinc-finger protein, serving an important part in the genome architecture as well as some biochemical processes. Over 70,000 CTCF binding DNA sites have been detected genome-wide, and most anchors of chromatin loops are demarcated with the CTCF binding. Various protein or RNA molecules interact with DNA-bound CTCF to conduct different biological functions, and potentially the interfaces between CTCF and its cofactors can be targets for drug development. Here we identify the effective region of CTCF in DNA recognition, which defines the exposed CTCF surface feature for the interaction of cofactors. While the zinc-finger region contributes the most in DNA association, its binding affinity varies based on different DNA sequences. To investigate the effectiveness of individual zinc-fingers, the key residues are mutated to inactivate the DNA binding ability, while the finger configuration and the spacing between fingers are preserved. The strategy is proved to be successful, while clear differences are observed in the DNA binding affinities among the 11 finger mutants and the result is consistent to previous studies in general. With the help of inactivated finger mutants, we identify the ineffective fingers and the dominant effective fingers, which form distinctive patterns on different DNA targets.

Exosomes are nanosized membrane microvesicles secreted by various living cells.They contain proteins,lipids,RNA,and a variety of other biological macromolecules.Exosomes play an important role in many pathological and physiological processes,such as antigen presentation in the immune system,repair of damaged tissues,and growth and migration of tumors.Tumor-derived or tumor-associated exosomes play a vital role in regulating the occurrence and development of tumors.The analysis and detection of exosomes in tumors is helpful for the early diagnosis of tumors and provide new treatment methods.This article reviews exosomes' origin,composition,and functions in the development,migration,diagnosis,and treatment of tumors and provides new ideas for the treatment of tumors.