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 explore any effect of excitatory and inhibitory multi-focal transcranial direct current stimulation (m-tDCS) on cortical functioning in healthy adults.Methods:Fifteen healthy participants received 20-minute excitatory and inhibitory episodes of m-tDCS targeting C1-C2-FC1-FC2. Finite element analysis and functional near-infrared spectroscopy were then used to model the normal component of the electric field (En) applied and to monitor the oxygenated hemoglobin (HbO), deoxygenated hemoglobin (HbR), and total hemoglobin (THb) concentrations in the targeted regions during the stimulation.Results:The excitatory protocol induced En values of 0.057V/m and 0.058V/m in the left and right hemispheres, respectively, with an average of 0.058V/m, while the inhibitory one evoked corresponding En values of -0.057V/m and -0.058V/m with an average of -0.058V/m. During excitatory m-tDCS, HbO and THb concentrations in the target cortices were higher than in the inhibitory protocol, with significant differences at FC1, FC2, and C2 for HbO, and at FC2 and C2 for THb. However, no significant inter-group differences in HbR concentrations were observed. Moreover, either protocol induced severe adverse reactions including pain, though the pain decreased with prolonged stimulation.Conclusions:Both excitatory and inhibitory m-tDCS modulate cortical function among healthy individuals. Excitatory m-tDCS is the more effective in enhancing cortical excitability.

Objective To explore the influencing factors of delayed bleeding after endoscopic gastric polypectomy in antithrombotic patients.Methods A retrospective case-control study was conducted,42 patients who experienced delayed bleeding after endoscopic gastric polypectomy during antithrombotic therapy at Dongguan Eighth People's Hospital from April 2021 to April 2024 were selected as the bleeding group,and 84 patients who underwent the same surgery during the same period without delayed postoperative bleeding were selected as the non-bleeding group.The general data,polyps and antithrombotic treatment of the two groups were compared.The influencing factors of delayed bleeding after endoscopic gastric polypectomy in patients with antithrombotic treatment were analyzed by conditional Logistic regression,and the predictive value was evaluated by the receiver operating characteristic(ROC)curve.Results The maximum polyp diameter of the bleeding group was larger than that of the non-bleeding group(P<0.05).There were significant differences in the number of antithrombotic drugs and the management of antithrombotic drugs between the two groups(P<0.05).Logistic regression analysis showed that the large maximum polyp diameter before surgery(OR=4.056,95%CI:2.116 to 7.775),the use of multiple antithrombotic drugs before surgery(OR=5.308,95%CI:1.516 to 18.583),and the withdrawal of all antithrombotic drugs but the application of renal replacement therapy(OR=7.167,95%CI:1.921 to 26.734)were the risk factors for postoperative delayed bleeding(P<0.05).ROC curve showed the area under the curve of the large maximum polyp diameter before surgery,the use of multiple antithrombotic drugs before surgery,and the withdrawal of all antithrombotic drugs but the application of renal replacement therapy for predicting postoperative delayed bleeding were 0.882(95%CI:0.812 to 0.932),0.702(95%CI:0.614 to 0.781)and 0.746(95%CI:0.661 to 0.820).Conclusion The large maximum polyp diameter before surgery,preoperative use of multiple antithrombotic drugs,and the application of renal replacement therapy are influencing factors for delayed bleeding after endoscopic gastric polypectomy in antithrombotic patients.

Objective To improve and refine the relevant regulations and guiding principles of warnings on drug instructions and labels in China.Methods This paper sorted out the drug instructions of small molecule anti-tumor drugs listed by the U.S.Food and Drug Administration(FDA)from 2005 to 2022,included the drugs mentioned in the QT interval prolongation risk,analyzed the clinical research and QT research results,and sorted out the identification and warning rules of the instructions.Results A total of 35 drugs were included,4 drugs wrote the risk of QT interval prolongation in the black box warning,21 drugs were wrote in the warning and precautions position,6 drugs were wrote in the adverse reaction section,and 2 drugs were only described under clinical pharmacology section.According to the severity of the QT interval prolongation caused by the drug and whether there were serious clinical consequences,they were displayed in the warnings(black box warnings),precautions(warnings and precautions)and adverse reactions in the instructions.Conclusion The aim of this article is to provide a reference for the writing of QT risk warning information of the instructions of domestic drug production enterprises and regulatory departments.It is recommended to clarify the severity of drug safety and the location of the instructions in clinical research,and continue to carry out safety monitoring and update the instructions in time after listing.

Objective To explore the application effectiveness of the"three-early education"model in professional quality education for medical psychology students.Methods Two groups were studied:medical psychology undergraduates of grade 2017 under conventional teaching and medical psychology undergraduates of grade 2019 under the"three-early education"model.Surveys were distributed at the end of the third academic year to evaluate their participation in research,clinical activities,and social practices,along with their satisfaction regarding the educational arrangement.Results Students from the grade 2019 cohort who received"three-early education"exhibited significantly higher rates of participation in research projects,clinical studies,and community engagement than students from the grade 2017 cohort who received traditional education(P＜0.05).In comparison to the grade 2017 cohort,the grade 2019 cohort showed significantly increased satisfaction levels in curriculum design,scheduling,evaluation methods,and professional proficiency(P＜0.05).Conclusion The"three-early education"model enhances the practical engagement and teaching satisfaction of medical psychology undergraduates,thereby improving their professional competence in the field of medical psychology.

Objective:To observe the intervention effect of personalized nutrition program combined with rehabilitation training in stroke rehabilitation patients.Methods:86 stroke rehabilitation patients who were admitted to our hospital from January 2023 to June 2024 were prospectively selected,they were divided into control group and study group according to the random number table method,with 43 cases in each group,the control group received rehabilitation training,while the study group received personalized nutrition program combine with rehabilitation training.Simple Fugl Meyer motor function(FMA)score,immune function indicators[immunoglobulin(Ig)A,IgG,complement C3,IgM,complement C4],National Institutes of Health Stroke Scale(NIHSS),nutritional status indicators[albumin(ALB),prealbumin(PA),total protein(TP),hemoglobin(HB)],Stroke Specific Quality of Life Scale(SS-QOL),Barthel Index(BI)score were compared between the two groups.Results:NIHSS score in the study group at 8 weeks after intervention was lower than that in the control group,and SS-QOL score,BI score,FMA score,IgM,IgA,IgG,complement C3,complement C4,ALB,HB,TP and PA were higher than those in the control group(P＜0.05).Conclusion:Personalized nutrition program combined with rehabilitation training in stroke rehabilitation patients,can reduce neurological damage,improve limb motor function,enhance nutritional status,immunity,and quality of life.

Objective To study the medication law of TCM compounds for ischemic stroke using data mining methods;To provide reference for clinical medication.Methods Literature about TCM treatment for ischemic stroke was retrieved from CNKI,VIP,Wanfang Data and SinoMed from May 31,2014 to May 31,2024.Drug frequency analysis,dosage analysis,property and taste attribution analysis,association rule analysis,factor analysis and clustering analysis were performed using Excel 2019,SPSS Modeler 18,SPSS 25 software.Results A total of 180 prescriptions for the treatment of ischemic stroke were included,involving 208 kinds of Chinese materia medica,with a total frequency of 1 996 times,of which 20 were high-frequency medicines(≥24 times),with Chuanxiaong Rhizoma,Angelicae Sinensis Radix,Pheretima,Astragali Radix,Paeoniae Radix Rubra and Carthami Flos being the most frequent;the efficacy of the medicines included activating blood circulation and removing blood stasis,tonifying the deficiency,pacifying the liver,calming the wind and clearing away heat;the main properties were warm,cold and neutral;the main tastes were bitter,sweet and pungent;the main meridians were liver,spleen,heart and lung meridians;among the drug dosages of drugs with frequency≥24,the mean dosage of Chuanxiong Rhizoma,Angelicae Sinensis Radix,Pheretima,Astragali Radix and Paeoniae Radix Rubra were 12.24,12.91,10.52,40.00,12.13 g,respectively.In the systematic clustering and complex network analysis,it was suggested that the core TCM prescriptions were:Xuefu Zhuyu Decoction with modified Banxia Baizhu Tianma Decoction,modified Chaihu Shugan Powder,Buyang Huanwu Decoction with modified Huangqi Guizhi Wuwu Decoction and modified Liujunzi Decoction.Conclusion TCM treatment for ischemic stroke mostly uses the methods of activating blood circulation and expelling phlegm,nourishing blood to promote blood circulation,clearing heat and cooling blood,and benefiting qi and neutralizing qi,which provides ideas and methods for following research.

Background and Objectives: There is no dedicated occlusive device for closing coronary artery fistulas (CAFs), and specific efficacy and safety data of various off-label occlusive devices for CAFs closure are scarce. Methods: Patients undergoing transcatheter closure of CAFs from January 2011 to December 2022 were included in the single-center retrospective study. The study population was divided into 2 groups: coils group (n=35) and patent ductus arteriosus (PDA) occluders group (n=66). Results: No significant intergroup differences were observed in demographic characteristics except age. The presence of multiple CAF origins (54.3% vs. 4.5%, p<0.001) and multiple draining sites (51.4% vs. 3.0%, p<0.001) were more common in the coils group. In contrast, the presence of aneurysm (72.7% vs. 14.3%, p<0.001), and large fistula (75.8% vs. 37.1%, p<0.001) were more prevalent in the PDA occluders group. The acute procedural success rate of the PDA occluders group was higher compared to that of the coils group (87.9% vs.62.9%, adjusted odds ratio [OR], 7.20; 95% confidence interval, 1.59–32.64; p=0.01).In addition, no significant intergroup differences were noted in both the recanalization rate (7.8% vs. 20%, p=0.107) and the reintervention rate (3.1% vs. 8.6%, p=0.342). Conclusions Transcatheter closure of CAFs using PDA occluders was associated with significantly higher acute procedural success rates compared to coil embolization with comparable late outcomes.