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.

Objective:To explore the application effect of eyebrow lift combined with periorbital muscle manipulatation in the treatment of upper eyelid skin relaxation.Methods:From February 2017 to June 2022, a total of 52 female patients with upper eyelid skin laxity aged 38-64 (43.2±5.0) years, admitted to the Department of Plastic Surgery and Laser Medicine, Beijing Anzhen Hospital were selected for treatment in eyebrow lift with sub-brow excision, removed excess skin and orbicularis oculi muscle, and cut off part of periorbital muscle, and the orbicularis orbicularis muscle at the lower edge of the incision was suspend and fixed to the periosteum of supraorbital margin.Results:After following up from 6 months to 1 year after surgery, the upper eyelid slack and crow′s feet of 52 patients were improved significantly, no obvious downward movement appeared in the eyebrows, and the surgical effect was satisfied.Conclusions:The treatment of upper eyelid skin relaxation in eyebrow lift combined with periorbital muscle manipulatation can significantly improve the upper eyelid slack and crow′s feet, and it is worthy of clinical application.

Objective To investigate the expression of spalt like transcription factor 4(Sall4)in pancreatic cancer tissues and its clinical significance,as well as the impact of inhibiting its gene expression on the migration and invasion of pancreatic cancer cells.Methods This study involved 64 patients with pancreatic cancer treated at the 2nd Affiliated Hospital of Kunming Medical University from January 2014 to January 2018.Immunohistochemical staining was used to detect the expression of Sall4 protein in adjacent non-tumor tissues and pancreatic cancer tissues,respectively.Real-time quantitative PCR was used to measure the mRNA expression levels of Sall4 in the cancerous and adjacent non-tumor tissues,respectively.The relationship between the clinicopathological data of these patients and the expression of Sall4 protein was also analyzed.The cells of high Sall4 expression were screened from the human pancreatic cancer cell lines PANC-1,Capan-1,SW 1990,HPAC,and HPAF-Ⅱ.The pancreatic cancer cells of high Sall4 expression were divided into three groups:control group,shRNA-1 group,and shRNA-2 group.The shRNA-1 and shRNA-2 groups were transfected with the corresponding Sall4 lentiviral inhibitory gene sequences,while the control group was transfected with the reagent without an interference sequence.Western blotting was used to measure the expression of Sall4,and cells with significantly reduced expression were selected for subsequent experiments.The transfected cells were then assessed for their invasive and migratory abilities.Results Among the 64 samples of pancreatic cancer tissues,28 cases(43.8％)were positive for Sall4 expression,a rate significantly higher than 5 cases(7.8％)in adjacent non-tumor tissues.Furthermore,16 cases exhibited strong positivity,while 12 cases showed moderate or weak positivity.Recurrence occurred in 11 pancreatic cancer patients.The difference was statistically significant.The expression of Sall4 was correlated with tumor differentiation,staging,and lymph node metastasis,suggesting that Sall4 positivity might be an independent risk factor affecting the prognosis of pancreatic cancer.Among the five cell lines,PANC-1 had the highest relative expression of Sall4 and was selected for further experiments.The shRNA-1 and shRNA-2 groups successfully suppressed the expression of Sall4,with the shRNA-1 group showing a more pronounced effect.Compared to the control group,the invasive and migratory abilities of SW480 cells were significantly reduced in the shRNA-1 group(P＜0.05).Conclusion Sall4 is highly expressed in pancreatic cancer tissues,and higher expression is associated with a greater likelihood of postoperative recurrence.Inhibiting the expression of Sall4 can significantly suppress the invasion and migration abilities of human pancreatic cancer cells.

College students, as an important talent reserve of national social development and the family’s future hope, their actions will bring greater influence to ordinary social groups. By analyzing the information demand of people in public health emergencies and the way of transmitting the disposal information of college students to the people, this paper studied the disposal behaviors of college students during the epidemic prevention and control period, such as information collection and feedback, emotional expression, behavioral norms and information dissemination. It was found that the behavior of college students in dealing with public health emergencies has a certain demonstration and guiding effect on society. In view of this effect, this paper put forward some educational activities, such as rational information analysis, effective relief of emotions, scientific analysis of the present situation, and positive dissemination of network information, so as to expand the demonstration function of college students in dealing with public health emergencies.

【Objective】 To investigate the effects of gallbladder cancer-associated fibroblasts (CAFs) on the migration of lymphatic endothelial cells (LECs) so as to elucidate the molecular mechanisms involved. 【Methods】 The CAFs and normal fibroblasts (NFs) were extracted by enzymatic digestion, and the supernatant (CM) of CAFs and NFs was collected. The levels of IL-6, IGFBP3 and other related cytokines were detected by semi-quantitative protein factor microarray and ELISA. The expressions of α-SMA (CAFs maker) and IGFBP3 in gallbladder cancer and para-cancer tissues were detected by immunohistochemistry, and the correlation of α-SMA and IGFBP3 expressions with clinicopathological characteristics were analyzed. LECs were cultured and divided into serum-free medium group (control group), CAF-CM co-culture group, NF-CM co-culture group, IGFBP3 group, and CAF-CM+IGFBP3 inhibitor (2-Deoxy-D-glucose, 2-DG) group according to different treatment. Transwell migration assays and wound healing assays were applied to analyze the migration ability of LECs under different treatment. The expressions of E-cadherin, N-cadherin and Vimentin were detected by Western blotting. 【Results】 Protein factor microarray and ELISA showed that the concentration of IGFBP3 in CAF-CM was significantly increased, and the expression of α-SMA was significantly related to lymph node metastasis, advanced TNM stage and expression of IGFBP3. IGFBP3 secreted from CAF-CM significantly promoted LECs migration, up-regulated the expression of N-cadherin and Vimentin, and down-regulated the expression of E-cadherin. Treatment with IGFBP3 inhibitor 2-DG could reverse the effect of CAF-CM on migration of LECs and related protein expressions. 【Conclusion】 Gallbladder CAFs promote the migration of LECs via releasing IGFBP3, which affects EMT transformation.

Objective: To investigate the cleaning effects of biofilm cleaning agent and two kinds of multi-enzyme detergents on endoscopic biofilm. Methods: Endoscopic biofilm model was established using pseudomonas aeruginosa, and soaked with No. 1 multi-enzyme detergent, No. 2 multi-enzyme detergent, and biofilm cleaning agent respectively. The control group was cleaned with sterile water. After 5, 10, and 15 minutes at room temperature, the cleaning effects were evaluated by bacteria counting method and scanning electron microscope. Arova was used for the comparison of viable counts among groups. Results: At 5, 10, and 15 minutes of soak, the standard colony counts (CFU/cm²) of biofilm was 5.31±0.10, 5.04±0.08 and 4.90±0.16 in the No.1 multi-enzyme detergent group, 5.53±0.30, 5.39±0.21 and 5.03±0.42 in the No.2 multi-enzyme detergent group, and 3.53±0.30, 3.01±0.07 and 2.82±0.26 in the biofilm cleaning agent group, and 7.92±0.21 in the blank control group. There was no significant difference in the colony counts between the two multi-enzyme detergent groups (P>0.05). However, the colony counts of biofilm cleaning agent group was less than that of the two multi-enzyme detergent groups (P<0.05), and decreased with time (P<0.05). Under scanning electron microscope, the biofilm cleaning agent group had the least residual biofilm and bacteria. Conclusion Biofilm cleaning agent can significantly improve the quality of endoscopic cleaning, and is worthy of clinical promotion.

OBJECTIVE: To investigate the effect of low-intensity pulsed ultrasound (LIPUS) on hematopoietic function in rats after combined chemotherapy with doxorubicin and cyclophosphamide. METHODS: Eighty rats were randomized into control group and LIPUS group (=40) for treatment with intraperitoneal injection of doxorubicin (2 mg/kg)+cyclophosphamide (20 mg/kg) for 4 consecutive days and continuous irradiation with LIPUS for 7 days following the injections, respectively. The white blood cells, red blood cells and platelets counts in each group were measured at 0, 4, 7, 9, 11, 14 and 18 days after the start of drug administration. The pathological sections of the bone marrow were examined at 0, 4 and 11 days, and the flow cytometry was performed for detecting the cell apoptosis; qPCR was performed for detecting the expressions of SCF, ICAM-1, and VCAM-1 mRNAs, and ELISA was used to detect the expressions of IL-3 and GM-CSF. RESULTS: The white blood cell count was significantly higher in LIPUS group than in the control group ( < 0.05). Histopathological examination of the bone marrow revealed significantly increased hematopoietic tissue in LIPUS group ( < 0.05). Flow cytometry demonstrated an obviously lower cell apoptosis rate in the bone marrow in LIPUS group than in the control group ( < 0.05). Compared with those in the control group, the mRNA expression levels of ICAM-1 and VCAM-1 as well as the protein levels of IL-3 and GM-CSF were significantly increased in LIPUS group ( < 0.05). CONCLUSIONS LIPUS can alleviate the hematopoietic damage after combined chemotherapy with doxorubicin with cyclophosphamide probably by increasing the expressions of ICAM- 1, VCAM-1, IL- 3, and GM-CSF.
Animals ; Bone Marrow ; Cyclophosphamide ; Doxorubicin ; Hematopoietic Stem Cell Transplantation ; Rats ; Ultrasonic Waves

Objective: To establish a monitoring model of stellate ganglion discharge in rats. Methods: Thirty healthy Sprague-Dawley rats of either sex, aged 6-7 weeks, weighing 230-270 g, were selected.The left stellate ganglion was isolated after anesthesia and hung on the platinum electrode head to observe its electrical signal.Heart rate was recorded immediately after successful anesthesia (T₀), immediately after the stellate ganglion was suspended in the electrode head (T₁), at 10, 20 and 30 min after the stellate ganglion was suspended in the electrode head (T_2-4), the frequency and amplitude of discharge of the stellate ganglion was recorded at T_1-4.After recording the nerve electrical signal at T₄, the stellate ganglion was locally infiltrated with 0.2% lidocaine 0.2 ml and then the frequency and amplitude of discharge was recorded 5 min later (T₅). The occurrence of Horner′s syndrome was considered as a sign of successful block, and the success of block was recorded. Results: There was no significant difference in heart rate at each time point (P>0.05). Paroxysmal clustered and rhythmically regular neuroelectrical activity of stellate ganglion was found at T_1-4, and there was no significant difference in the frequency and amplitude of discharge at each time point (P>0.05). The frequency and amplitude of discharge of stellate ganglion were significantly decreased at T₅ than at T_1-4 (P<0.01). Conclusion The discharge monitoring model of stellate ganglion is successfully established in rats.

Objective: To investigate the value of NPM1 and FLT3 gene mutation combined with bone marrow imaging detection in the prognosis judgement of initial treatment cytogenetically normal acute myeloid leukemia (CN-AML). Methods: The clinical data of 100 patients (non-M₃ type) with primary and initial treatment CN-AML from January 2010 to January 2014 in the Peace Hospital Affiliated of Changzhi Medical College were retrospectively analyzed. All patients were enrolled in the bone marrow imaging examination on the end day of induction treatment or the first day after the end of induction treatment (T time point). Univariate and multivariate prognostic analyses were performed on AML patients according to FLT3 and NPM1 gene status,bone marrow juvenile cell ratio at T time point. Results: A total of 100 patients included 36 cases with FLT3 gene mutation and 44 cases with NPM1 gene mutation. The complete remission (CR) rate of CN-AML patients was 13.9% (5/36) and 71.9% (46/64), respectively (P < 0.01), 2-year recurrence-free survival (RFS) rate was 5.6% and 59.8%, respectively (P < 0.01), 2-year overall survival (OS) rate was 15.6% and 66.2%, respectively in FLT3⁺ group and FLT3^- group (P < 0.01). The median RFS and median OS time in FLT3⁺ group was 6.9 months and 9.4 months, respectively, and the median RFS and median OS time in FLT3^- group had not yet reached. There were no significant differences of all the indexes between the two groups (all P < 0.01). And there were no significant differences in CR rate, 2-year RFS rate and 2-year OS rate between NPM1⁺ group and NPM1^- group (all P > 0.05). The CR rate, 2-year RFS rate and 2-year OS rate in NPM1⁺ FLT3^- group were better than those in NPM1^- FLT3^-, NPM1^- FLT3⁺ and NPM1⁺ FLT3⁺ groups; NPM1^- FLT3⁺ and NPM1⁺ FLT3⁺ groups had the worst prognosis, and there were no statistical differences in the CR rate, RFS and OS time between the two groups (all P > 0.05). The prognosis of the patients in bone marrow juvenile cell ratio < 0.05 group at T time point was better than that in ratio ≥0.05 group (all P < 0.05). CN-AML patients were classified into the good prognosis group (NPM1^- FLT3^-), the medium prognosis group (NPM1⁺ FLT3^-), and the poor prognosis group (NPM1^- FLT3⁺ and NPM1⁺ FLT3⁺) according to the FLT3 and NPM1 genes. The good prognosis group+ the ratio of bone marrow juvenile cells at T time point < 0.05 group, the good prognosis group+ the ratio of bone marrow juvenile cells at T time point ≥0.05 group, the medium prognosis group+ the ratio of bone marrow juvenile cells at T time point < 0.05 group had no statistical differences in CR rate, 2-year RFS rate and 2-year OS rate (all P > 0.05). The medium prognosis group+ the ratio of bone marrow juvenile cells at T time point ≥0.05 group, the poor prognosis group+ the ratio of bone marrow juvenile cells at T time point < 0.05 group had the equivalent prognosis, and the average prognosis was moderate; the poor prognosis group+ the ratio of bone marrow juvenile cells at T time point ≥ 0.05 group had the worst prognosis. According to Cox multivariate regression analysis, FLT3 gene mutation and the ratio of bone marrow juvenile cells at T time point were independent influencing factors for RFS and OS in CN-AML patients (all P < 0.05). NPM1 was an independent prognosis factor affecting RFS and OS of FLT3^- patients (all P < 0.05). Conclusions After induction chemotherapy, the responsiveness and sensitivity of AML patients to chemotherapy regimen can be assessed early and objectively according to molecular genetics and the ratio of bone marrow juvenile cells at T time point, which has a certain value in the prognosis judgement.