Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

OBJECTIVE: To explore the role of CDGSH iron-sulfur domain 2 (CISD2) in patients with sepsis-related myocardial injury (SMI) and its predictive value for 28-day prognosis and myocardial damage through clinical studies and cell experiments. METHODS: A retrospective study was conducted. Adult patients diagnosed with sepsis admitted to the critical care medicine of Third Affiliated Hospital of Qiqihar Medical University from January 2023 to January 2024 were enrolled. The clinical data, laboratory indicators, expression level of CISD2 mRNA in peripheral blood mononuclear cells (PBMC) 24 hours after admission, and 28 days prognosis were collected. Patients were divided into SMI group [left ventricular ejection fraction (LVEF) < 0.50 or LVEF decreased by ≥ 10% from baseline] and sepsis non-myocardial injury group based on LVEF. The expression levels of CISD2 mRNA were compared between the two groups, and the correlation between CISD2 and myocardial injury was analyzed. Patients were divided into the low-expression group (CISD2 mRNA < 0.5 copy/μL) and the high-expression group (CISD2 mRNA ≥ 0.5 copy/μL) based on the expression of CISD2 mRNA, and into the survival group and the death group based on the prognosis at 28 days. The clinical characteristics were analyzed between the groups. Multivariate Logistic regression was used to analyze the independent predictors of 28-day mortality in patients with sepsis. The predictive value of CISD2 for myocardial damage and 28-day prognosis in patients with sepsis were evaluated by using the receiver operator characteristic curve (ROC curve). In addition, in vitro experiments using human AC16 cardiomyocytes was conducted. The cells were divided into control group, lipopolysaccharide (LPS) group, the LPS+transfection group with overexpression of CISD2 plasmid (LPS+p-CISD2 group), and the LPS + transfection group with negative control plasmid (LPS+p-NC group). The mRNA expression of CISD2 in cells were detected by real-time quantitative polymerase chain reaction (RT-qPCR), the protein expression of CISD2 in cells were detected by Western blotting, and the cell viability was determined by cell counting kit-8 (CCK-8). RESULTS: A total of 85 sepsis patients were included, with 32 developing myocardial injury and 53 without myocardial injury. There were 40 cases of low expression of CISD2 and 45 cases of high expression of CISD2. At 28 days, 60 cases survived and 25 cases died. The mRNA expression of CISD2 in the SMI group was significantly lower than that in the sepsis non-myocardial injury group (copy/μL: 0.41±0.09 vs. 0.92±0.13, P < 0.05). CISD2 was significantly correlated with myocardial injury in patients with sepsis (r = 0.729, P < 0.05). The proportion of LVEF < 0.50 (67.50% vs. 11.11%), sequential organ failure score (SOFA: 15.63±2.15 vs. 11.12±1.52), and acute physiology and chronic health evaluation II (APACHEII: 29.49±3.51 vs. 22.41±2.61) in the CISD2 low-expression group were significantly higher than those in the CISD2 high-expression group (all P < 0.05), while there were no significantly differences in other indicators. The Kaplan-Meier survival curve showed that the 28-day survival time of sepsis patients with in the CISD2 low-expression group was significantly shorter than that in the CISD2 high-expression group (Log-rank test: χ ² = 5.601, P < 0.05). The proportion of CISD2 low-expression and the proportion of LVEF < 0.50 in the survival group were both higher than those in the death group (80.00% vs. 33.33%, 64.00% vs. 26.67%, both P < 0.05), while there were no significantly differences in other indicators. Multivariate Logistic regression analysis showed that CIDS2 and LVEF were independent predictive factors for 28-day mortality in patients with sepsis [CIDS2: odds ratio (OR) = 3.400, 95% confidence interval (95%CI) was 1.026-11.264, P = 0.045; LVEF: OR = 2.905, 95%CI was 1.029-8.199, P = 0.044]. ROC curve analysis showed that when CISD2 was expressed at a low level, patients with sepsis were at high risk of death within 28 days and myocardial injury. The sensitivity of CISD2 in predicting the 28-day mortality of patients with sepsis was 80.00%, and the specificity was 66.67%, and the area under the curve (AUC) was 0.733 (95%CI was 0.626-0.823). The sensitivity of CISD2 in predicting myocardial injury in patients with sepsis was 83.87%, the specificity was 74.07%, and the AUC was 0.790 (95%CI was 0.688-0.871). In addition, compared with the control group, the mRNA and protein expressions of CISD2 as well as the cell activity in the LPS group were significantly decreased. The mRNA and protein expressions of CISD2 and the activity of cardiomyocytes transfected with p-CISD2 were significantly increased. CONCLUSIONS CISD2 plays a protective role in sepsis-associated myocardial injury and has good predictive value for 28-day prognosis and myocardial injury.
Humans ; Sepsis/metabolism* ; Prognosis ; Retrospective Studies ; Male ; Female ; Middle Aged ; RNA, Messenger/genetics* ; Aged ; Myocardium/metabolism*

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective To construct a list of quality scoring criteria for the attached sheet to the summary page of inpatient cases to achieve quantitative evaluation of the data quality.Methods It uses the Data Quality Management model of the American AHIMA as the evaluation framework to develop the list of data quality scoring criteria for the attached sheet,and score in Attached Sheet to the Summary Page of Inpatient Cases issued by the Hubei Provincial Health Commission as a demonstration.Results The average score of the 40 items in Attached Sheet to the Summary Page of Inpatient Casesis 6.725 out of 10.The main quality defects include that all items fail to clarify the person responsible for filling or the time limit for filling.In addition,some items are duplicated with the summary page(35%)or do not have a summary nature(40%).Conclusion Significant room exists for the improvement in the data quality of the attached sheet,especially in defining the person responsible and the time limit for filling in when setting up the items,making sure that the items supplement and extend the summary page,and applying effective quality control methods to the items.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Repairing chronic refractory wounds on the body surface is a complex medical problem involving all stages of wound healing. In recent years, stem cells (SCs) and tissue engineering (TE) have brought hope for repairing chronic refractory wounds. SCs have excellent regenerative and paracrine effects; various TE strategies have the potential to repair chronic refractory wounds on the body surface and also improve the delivery efficiency of SCs. This article reviews the pathological characteristics of chronic refractory wounds, SCs used to repair chronic refractory wounds, and SC-based TE wound repair strategies.

Objective:To compare the predictive values of Bologna Outcome Algorithm for Stroke (BOAS) , Acute Stroke Registry and Analysis of Lausanne (ASTRAL) and Preadmission Comorbidities, Level of Consciousness, Age, and Focal Neurologic Deficit (PLAN) for stroke-associated pneumonia (SAP) and prognosis in elderly stroke patients in ICU.Methods:Using the convenient sampling method, a total of 198 elderly stroke patients who were hospitalized in ICU of Neurology Department of Henan Provincial People's Hospital were selected as the research objects from June 2017 to December 2019. According to whether SAP occurred within 4 weeks, patients were divided into SAP group, non-SAP group, severe SAP subgroup and mild SAP subgroup. According to the outcome within 4 weeks, they are divided into the poor prognosis group and the good prognosis group. The differences of BOAS, ASTRAL and PLAN scores among different groups were recorded and compared. ROC curve was used to analyze and compare the predictive performance of the three scales for SAP and its prognosis.Results:Pairwise positive correlation was found between BOAS, ASTRAL and PLAN scores ( P<0.05) . All the three scores of patients in SAP group were significantly higher than those in the non-SAP group, and ASTRAL and PLAN scores in severe SAP subgroup were higher than those in mild SAP subgroup, and the differences were significant ( P<0.05) . The area under ROC curve ( AUC) of BOAS, ASTRAL and PLAN scores were respectively 0.610, 0.692 and 0.705, and the AUC for predicting severe SAP were respectively 0.613, 0.661 and 0.709. In the SAP group and the non-SAP group, the scores of three scales of patients in the poor prognosis group were higher than those in the good prognosis group, and the differences were significant ( P<0.05) . The AUC of BOAS, ASTRAL and PLAN scores in the SAP group for predicting poor prognosis were respectively 0.736, 0.757 and 0.716, and AUC in the non-SAP group were respectively 0.699, 0.731 and 0.631. Conclusions:BOAS, ASTRAL and PLAN scores have certain predictive value for the SAP and prognosis of elderly patients in ICU. Among them, PLAN score has better predictive performance for SAP and ASTRAL has better predictive performance for prognosis.

Objective:To investigate the effect of lncRNA HOTAIR on the radiosensitivity of glioma cells and its underlying mechanism.Methods:The negative control plasmid, HOTAIR silencing plasmid, miR-NC over expressing plasmid, miR-17-5p over expressing plasmid were transfected into U87R cells, and assigned intothe silencing control, HOTAIR silencing, miR-NC over expressing and miR-17-5 pover expressing groups. Cells in the the above groups were irradiated at a dose of 4Gy, and recorded as silencing control+ 4Gy group, HOTAIRsilencing+ 4Gy group, miR-NC over expressing+ 4Gy group and miR-17-5p over expressing+ 4Gy group. The HOTAIR silencing plasmid, miR-NC suppressing plasmid and miR-17-5p suppressing plasmid were co-transfected into U87R cells and recorded as the HOTAIR silencing+ miR-NC suppressing group and HOTAIR silencing+ miR-17-5p suppressing group. All procedures were transfected by the liposome method. The expression of miR-17-5p and HOTAIR was detected by qRT-PCR. The radio sensitivity of glioma cells was evaluated by cell clone formation assay. The cell apoptosis was assessed by flow cytometry. The fluorescence activity was assessed by dual luciferase reporter assay.Results:HOTAIR was highly expressed in the radiation-resistant glioma cells. Silencing HOTAIR and over-expressing miR-17-5p could increase the radiosensitivity of U87R cells and promote radiation-induced apoptosis of U87R cells. HOTAIR could target and regulate the miR-17-5p expression. Suppressing miR-17-5p reversed the effect of silencing HOTAIR on U87R cell sensitization and promoting radiation-induced U87R cell apoptosis.Conclusions:Silencing lncRNA HOTAIR yields radiation sensitization and promotes radiation-induced apoptosis in glioma cells. The mechanism may be related to the regulation of miR-17-5p.

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

The membrane protein claudin-3 (CLDN3) is critical for the formation and maintenance of tight junction and its high expression has been implicated in dictating malignant progression in various cancers. However, the post-translational modification of CLDN3 and its biological function remains poorly understood. Here, we report that CLDN3 is positively correlated with ovarian cancer progression both and Of interest, CLDN3 undergoes -palmitoylation on three juxtamembrane cysteine residues, which contribute to the accurate plasma membrane localization and protein stability of CLDN3 Moreover, the deprivation of -palmitoylation in CLDN3 significantly abolishes its tumorigenic promotion effect in ovarian cancer cells. By utilizing the co-immunoprecipitation assay, we further identify ZDHHC12 as a CLDN3-targating palmitoyltransferase from 23 ZDHHC family proteins. Furthermore, the knockdown of ZDHHC12 also significantly inhibits CLDN3 accurate membrane localization, protein stability and ovarian cancer cells tumorigenesis Thus, our work reveals -palmitoylation as a novel regulatory mechanism that modulates CLDN3 function, which implies that targeting ZDHHC12-mediated CLDN3 -palmitoylation might be a potential strategy for ovarian cancer therapy.