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.

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.

BACKGROUND:Diabetic ulcers are a common complication of diabetes mellitus,which is manifested as foot ulcers complicated with infection,long treatment cycle,high disability rate and mortality rate,and brings a heavy burden to patients and social care. OBJECTIVE:To review the mechanism of action and the latest treatment progress of traditional Chinese medicine(TCM)in the treatment of diabetic ulcers,and to provide a basis for further theoretical research and clinical application. METHODS:CNKI,WanFang Database and PubMed database were searched for relevant literature using the keywords of"diabetic ulcer,medicinal herb,inflammation,interleukin-1β,interleukin-6,tumor necrosis factor,hypersensitive C-reactive protein,γ-interferon,interleukin-4,interleukin-10"in Chinese and English,respectively.The relevant literature in recent years was searched,and finally 75 articles were included for review. RESULTS AND CONCLUSION:The high glucose environment of the body will increase the level of pro-inflammatory cytokines,so that diabetic ulcer wounds are in a state of chronic inflammatory response for a long time,and difficult to heal or even not heal.TCM has summed up a lot of experience in the long-term struggle with diabetic ulcer.At present,TCM divides diabetic ulcers into four syndrome types:dampness and heat poison syndrome,blood and blood stasis obstruction pattern,heat poison injury Yin pattern,and Qi and blood deficiency syndrome,as well as representative prescriptions for treatment.According to their clinical characteristics,diabetic ulcers can be also divided into three stages:primary,middle and late stages.Different treatment methods are proposed:"clear method,""warm and clear combined use"and"maintenance method."Under the guidance of dialectical typing and staging of TCM,TCM monomers,extracts and compounds inhibit the inflammatory response and promote the healing of diabetic ulcers by down-regulating the expression of pro-inflammatory factors and/or up-regulating the expression of anti-inflammatory factors.Compared with modern medicine,TCM has significant advantages in the treatment of diabetic ulcers.There are many TCM monomers,extracts and compounds for the treatment of diabetic ulcers,such as angelica,curcumin,improved Chonghe ointment,Sanhuang blood exhaustion prescription and sore-ulcer I.formula,etc.It has been found that TCM for the treatment of diabetic ulcers is mainly heat-clearing and detoxifying,invigorating blood circulation and removing blood stasis,and amassing sores and muscle-building drugs,and the frequency of use,treatment scope and therapeutic effect of TCM compounds are obviously better than those of TCM monomers and extracts.Among them,the most commonly used are the Sanhuang blood exhaustion prescription and the sore-ulcer I as well as prescription for the treatment of damp heat toxicity syndrome and Zizhu ointment for the treatment of non-ischemic diabetic ulcers.However,there are also some shortcomings in the treatment of diabetic ulcers with TCM.First,there are few clinical syndrome studies on diabetic ulcers.Secondly,there are a wide variety of TCM monomers,extracts and compounds for the treatment of diabetic ulcers,and the relevant research is insufficiently in-depth.Finally,the research on the mechanism underlying TCM treatment of diabetic ulcers is still in the preliminary exploration stage,and the mechanism of action still needs to be further explored.In the future,it is necessary to strengthen the research on the pharmacology of TCM and the clinical syndrome of diabetic ulcers,analyze the potential targets and related signaling pathways of TCM in the treatment of diabetic ulcers,give full play to the therapeutic advantages of TCM with multiple targets,multiple pathways,multiple levels and multiple systems,and develop TCM with significant efficacy,active ingredients and clear targets.

Objective The plasma von Willebrand factor(vWF)level in patients with primary microvascular angina(PMVA)were measured to evaluate the vascular endothelial function of the patients.The change of vWF level in patients after the treatment with Shexiangbaoxin Pill were observeg.Methods Totally 69 patients who were definitely diagnosed as PMVA,They were randomly divided into conventional treatment group(33cases)and ShexiangBaoxin Pill group(36cases).The plasma vWF levels of the two groups were measured before and after treatment.Results The level of vWF before treatment in conventional treatment group was(50.93±32.98)μg/L.The level of vWF before treatment in ShexiangBaoxin Pill group was(27.45±25.02)μg/L.The level of vWF in conventional treatment group after treatment was(49.65±35.12)μg/L.The level of vWF after treatment in ShexiangBaoxin Pill group was(17.37±15.68)μg/L.The difference of vWF decrease in Baoxin Pill group after treatment(10.08±16.47)μg/L,was lower than that in conventional treatment group(1.28±12.37)μg/L,the difference is significant(P<0.05).Conclusion Shexiang Baoxin Pill has the function of protecting vascular endothelium,and PMVA patients can benefit from treatment.

Purpose/Significance To explore the training path of smart medical compound talents with both medical knowledge and artificial intelligence(AI)engineering technology under the background of education digital transformation.Method/Process By apply-ing the methods of educational practice and literature research,the paper analyzes the challenges faced by education digital transforma-tion,expounds the construction method of the"real-virtual"digital transformation model of smart medical education,and puts forward the training path of smart medical talents.Result/Conclusion Under the background of education digital transformation,it is necessary to reshape the concept of smart medical education and innovate the evaluation mode of smart medical education,realize the reform of"teach-ing""learning"and"management"through the smart campus system.

Bladder cancer is the most common malignant tumor in the urinary system.Currently,the clinical treatment options for bladder cancer mainly include surgery,chemotherapy,radiotherapy,immunotherapy,targeted therapy,photodynamic therapy,combination therapy,etc.The conventional treatment and administration strategies for bladder cancer primarily depend on the tumor stage and the extent of metastasis.However,in the process of non-surgical treatment,drugs lack specificity and targeting.Once the dosage is improperly controlled,drugs will damage normal cells when attacking cancer cells,which will lead to poor efficacy and multiple side effects.Nanomedicine is an emerging interdisciplinary field that utilizes nanomaterials and technologies in nanomedicine to provide disruptive technologies for traditional treatments,with advantages such as targeted delivery and high efficiency with low toxicity.Many nanotechnologies have become hot topics in clinical research in the field of medicine.Functionalized nanoparticles can actively or passively target specific cells within target organs,such as bladder cancer cells,by altering their surface properties,thereby enhancing drug delivery precision,reducing damage to normal cells,and improving treatment efficacy.This article provides an overview of the progress in classical and novel treatment approaches to bladder cancer,with a particular focus on the potential applications and future development directions of nanotechnology in the treatment of bladder cancer,providing important reference for personalized therapy and clinical translation in bladder cancer.

Objective:To analyze levels of oral Streptococcus sanguinis( Ss)in middle-aged and elderly patients with primary microvascular angina(PMVA)and changes in vascular endothelial function. Methods:In this case-control study, 21 middle-aged and elderly patients diagnosed with PMVA at the Department of Cardiology, Hangzhou Red Cross Hospital between January 2019 and July 2022(the PMVA group)were recruited, with ages ranging from 45 to 80(63.4±12.3)years, while 23 healthy individuals receiving health checkups during the same period served as the control group, with ages ranging from 48-76(62.5±6.5)years.The 21 middle-aged and elderly PMVA patients underwent tests for the measurement of subgingival plaque Ss levels of the oral cavity and levels of plasma vascular von Willebrand factor(VWF)and homocysteine(Hcy). Pearson linear regression analysis was conducted.Results:Ss was not found in subgingival plaque of the oral cavity in the control group, but low levels of Ss were detected in patients from the PMVA group(percentage: 1.754×10 -4; 6.218×10 -5, 4.450×10 -4). The VWF level in the PMVA group was higher than in the control group[(20.22 ± 4.44)μg/L vs.(12.00 ± 6.60)μg/L, t=4.890, P<0.01]. There was no statistical difference in the Hcy level between the PMVA group and the control group[(15.28±6.40)μmol/L vs.(12.86±2.63)μmol/L, t=1.615, P>0.05]. There was no significant correlation between Ss levels and VWF levels in the PMVA group( r=0.038, P>0.05). Conclusions:Ss can be detected in subgingival plaque of the oral cavity in PMVA patients, but not in healthy middle-aged and elderly people.The VWF level in PMVA patients is significantly higher than in healthy people, indicating that vascular endothelial function is impaired in middle-aged and elderly PMVA patients.However, there is no correlation between subgingival plaque Ss levels of the oral cavity and VWF levels in PMVA patients.

Objective:To investigate the characteristics and causes of endplate injury in the oblique lateral interbody fusion for the treatment of lumbar diseases, and summarize the precaution of endplate injury.Methods:Thirty-five cases of endplate injury were observed, which were originally treated with oblique lateral interbody fusion with or without pedicle screw fixation from October 2014 to December 2017. There were 7 males and 28 females, and the age ranged from 51 to 78 years old (averagely 62.8±8.13 years). There were 2 cases of lumbar disc degeneration, 10 cases of lumbar canal stenosis, 17 cases of lumbar degenerative spondylolisthesis, 2 cases of lumbar spondylolysis with or without spondylolisthesis, and 4 cases of lumbar degenerative scoliosis. Lesion sites contained L 3,4 in 2 cases, L 4,5 in 21 cases, L 2-4 in 3 cases, L 3-5 in 4 cases, L 2-5 in 3 cases and L 1-5 in 2 cases. Preoperative bone mineral density examination revealed there were 7 cases of T>-1 SD, 24 cases of -2.5 SD

Poor experience of teacher-student interaction and low user loyalty exist in MOOC (massive open online courses).Therefore,the campus open online courses (COOC),a network teaching platform,was developed to integrate traditional classroom teaching and network teaching and to build an online-offline curriculum system according to professional training scheme of school.The online-offline teaching design and learning evaluation in COOC platform was also developed.The running data of COOC platform showed that the online-offline learning evaluation model has guiding impact on students' learning attitude because it can record the students' learning process and learning effect,which can enhance students' active participation in self-directed learning.The learning evaluation model in COOC is objective and scientific,which is helpful to improve the quality of teaching and learning.

Huntington's disease (HD) is a neurodegenerative disease caused by a polyglutamine expansion in the huntingtin (Htt) protein. Mutant Htt causes synaptic transmission dysfunctions by interfering in the expression of synaptic proteins, leading to early HD symptoms. Synaptic vesicle proteins 2 (SV2s), a family of synaptic vesicle proteins including 3 members, SV2A, SV2B, and SV2C, plays important roles in synaptic physiology. Here, we investigated whether the expression of SV2s is affected by mutant Htt in the brains of HD transgenic (TG) mice and Neuro2a mouse neuroblastoma cells (N2a cells) expressing mutant Htt. Western blot analysis showed that the protein levels of SV2A and SV2B were not significantly changed in the brains of HD TG mice expressing mutant Htt with 82 glutamine repeats. However, in the TG mouse brain there was a dramatic decrease in the protein level of SV2C, which has a restricted distribution pattern in regions particularly vulnerable in HD. Immunostaining revealed that the immunoreactivity of SV2C was progressively weakened in the basal ganglia and hippocampus of TG mice. RT-PCR demonstrated that the mRNA level of SV2C progressively declined in the TG mouse brain without detectable changes in the mRNA levels of SV2A and SV2B, indicating that mutant Htt selectively inhibits the transcriptional expression of SV2C. Furthermore, we found that only SV2C expression was progressively inhibited in N2a cells expressing a mutant Htt containing 120 glutamine repeats. These findings suggest that the synaptic dysfunction in HD results from the mutant Htt-mediated inhibition of SV2C transcriptional expression. These data also imply that the restricted distribution and decreased expression of SV2C contribute to the brain region-selective pathology of HD.
Aging ; metabolism ; Animals ; Brain ; metabolism ; pathology ; Cell Line, Tumor ; Gene Expression ; physiology ; Huntingtin Protein ; genetics ; metabolism ; Membrane Glycoproteins ; metabolism ; Mice ; Mice, Transgenic ; Mutation ; Nerve Tissue Proteins ; metabolism ; RNA, Messenger ; metabolism ; Transcription, Genetic ; physiology