Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective UPLC-MS/MS bio-analysis method was developed for the simultaneous determination ofberberine,naringin,hesperidin,and neohesperidin in plasma of rats.Methods UPLC Acquity BEH C18 (50 rmm × 2.1 mm,1.7 μm) column was used,mobile phases were containing 0.05％ formic acid and 2 mmol/L ammonium formate in water (A)-containing 0.05％ formic acid in acetonitrile (B) as the mobile phase gradient elution;SD rats were randomly divided into oral administration berberine group,Citrus aurantium extract group,and berberine and C.aurantium extract compatibility group.Results UPLC-MS/MS method could be applied to determination of berberine,naringin,hesperidin,and neohesperidin,method validation meets the requirements of biological sample analysis.When rats were administered with berberine and C.aurantium extract compatibility,the plasma concentration of berberine was much more than single dose of berberine group and the bioavailability of berberine was increased.Meanwhile,naringin and neohesperidin can be detected in rat's plasma.Conclusion The bioavailability of flavonoids is significantly improved as well compared to the single dose of C.aurantium extract.This suggests that berberine and C.aurantium extract compatibility has significant drug-drug interaction.

Objective To evaluate the diagnostic value of prostate imaging reporting and data system version 1 (PI-RADS V1) and version 2 (PI-RADS V2) for detection of prostate cancer (PCa) in the transition zone (TZ).Methods Seventy-seven patients with suspicious lesions in TZ on mpMRI were scored according to the PI-RADS system (V1 and V2) before MR-TRUS fusion guided biopsy prospectively.In all of the patients with suspicious tumors,respectively at least one lesion with a PI-RADS V1 assessment category of ≥3,was selected for biopsy.Independent sample t test was used to compare scores of PI-RADS V1 and V2 between PCa and benign prostatic hyperplasia (BPH).The diagnostic performance of PI-RADS V 1 and V2 for detection of PCa in the transition zone was compared by analyzing ROC basing on the results of MR-TRUS fusion guided biopsy.Results A cohort of 77 patients was performed including 31 cases of PCa (32 cores) and 46 cases of BPH (51 cores).PCa (V1:1 1.50±2.79;V2:4.28±0.99) had significantly higher scores of both PI-RADS V1 and PI-RADS V2 than BPH(V1:7.51± 1.63;V2∶2.61 ±0.67) (P＜0.05).Using a PI-RADS V1 score cut-off ≥ 11,sensitivity and specificity in group PCa and BPH were calculated,which were 68.8％(22/32) and 96.1％(49/51) with a area under curve of 0.869;using a PI-RADS V2 score cut-off ≥4,which were 75.0％ (24/32) and 90.2％ (46/51) with a area under curve of 0.888,respectively.Conclusions PI-RADS system can indicate the likelihood of PCa of suspicious lesions in TZ on Mp-MRI.PI-RADS V2 perform better than V 1 for the assessment of prostate cancer in TZ.

OBJECTIVETo compare the application valuable of flexible spatial scan statistics and kulldorff scanning window in the cluster detection and early warning of hepatitis A.

METHODSThe case numbers and incidence data of hepatitis A in 2012 for all the counties (cities, districts)in Yunnan province were collected from China Information System for Disease Control and Prevention and the total number was 1 335. By extracting the time length by month, the flexible spatial scan statistics was tested by retrospective analyses of hepatitis A data in Yunnan in 2012 and compared the results with the Kulldorff circular scan statistic analyses.

RESULTSThe results of flexible scanning window showed that there were fifteen hepatitis A spatial clusters in Yunnan province in 2012 and in July, these areas including Gejiu county, Mengzi county and Wenshan county had the strongest clusters (the log likelihood ratio (LLR) = 52.66, P = 0.001). The results of Kulldorff scanning window showed that there were twenty hepatitis A spatial clusters and these areas including Gejiu county, Hekou county, Maguan county, Mengzi county, Pingbian county, Wenshan county had the strongest clusters (LLR = 47.82, P = 0.001). The results of the flexible scanning window were the same as the actual monitoring results. But the results of Kulldorff scanning window showed that in May and June some areas without incidence had the clusters.

CONCLUSIONFlexible scanning window can detect the monthly clusters of the Hepatitis A. Flexible scanning window had a higher accuracy than Kulldorff irregular circular scanning window. Flexible spatial scan statistics had the value in the use of spatial aggregation detecting on hepatitis A.

Objective To compare the application valuable of flexible spatial scan statistics and kulldorff scanning window in the cluster detection and early warning of hepatitis A.Methods The case numbers and incidence data of hepatitis A in 2012 for all the counties( cities, districts) in Yunnan province were collected from China Information System for Disease Control and Prevention and the total number was 1 335.By extracting the time length by month, the flexible spatial scan statistics was tested by retrospective analyses of hepatitis A data in Yunnan in 2012 and compared the results with the Kulldorff circular scan statistic analyses.Results The results of flexible scanning window showed that there were fifteen hepatitis A spatial clusters in Yunnan province in 2012 and in July, these areas including Gejiu county, Mengzi county and Wenshan county had the strongest clusters(the log likelihood ratio(LLR) =52.66,P=0.001). The results of Kulldorff scanning window showed that there were twenty hepatitis A spatial clusters and these areas including Gejiu county, Hekou county, Maguan county, Mengzi county, Pingbian county, Wenshan county had the strongest clusters (LLR=47.82,P=0.001).The results of the flexible scanning window were the same as the actual monitoring results.But the results of Kulldorff scanning window showed that in May and June some areas without incidence had the clusters.Conclusion Flexible scanning window can detect the monthly clusters of the Hepatitis A.Flexible scanning window had a higher accuracy than Kulldorff irregular circular scanning window. Flexible spatial scan statistics had the value in the use of spatial aggregation detecting on hepatitis A.

Objective To compare the application valuable of flexible spatial scan statistics and kulldorff scanning window in the cluster detection and early warning of hepatitis A.Methods The case numbers and incidence data of hepatitis A in 2012 for all the counties( cities, districts) in Yunnan province were collected from China Information System for Disease Control and Prevention and the total number was 1 335.By extracting the time length by month, the flexible spatial scan statistics was tested by retrospective analyses of hepatitis A data in Yunnan in 2012 and compared the results with the Kulldorff circular scan statistic analyses.Results The results of flexible scanning window showed that there were fifteen hepatitis A spatial clusters in Yunnan province in 2012 and in July, these areas including Gejiu county, Mengzi county and Wenshan county had the strongest clusters(the log likelihood ratio(LLR) =52.66,P=0.001). The results of Kulldorff scanning window showed that there were twenty hepatitis A spatial clusters and these areas including Gejiu county, Hekou county, Maguan county, Mengzi county, Pingbian county, Wenshan county had the strongest clusters (LLR=47.82,P=0.001).The results of the flexible scanning window were the same as the actual monitoring results.But the results of Kulldorff scanning window showed that in May and June some areas without incidence had the clusters.Conclusion Flexible scanning window can detect the monthly clusters of the Hepatitis A.Flexible scanning window had a higher accuracy than Kulldorff irregular circular scanning window. Flexible spatial scan statistics had the value in the use of spatial aggregation detecting on hepatitis A.

ObjectiveTo investigate the effects of tirofiban on microvascular flow in infarction zone after coronary reperfusion in pigs with acute myocardial infarction (AMI),and to explore its mechanism of decreasing microvessel obstruction (MO) and the relationship with inflammatory factors. MethodsChinese mini pigs were randomized into control group and tirofiban treatment group.Acute myocardial infarction was induced by balloon occluding the medium segment of the left anterior descending artery for 90 min,and then reperfusion was created by withdrawing the balloon.The infarct myocardium and MO area were detected with delayed enhancement multi-slice spiral CT (DE-MSCT),the serum levels of IL-6 and IL-10 were measured with enzyme linked immunosorbent assay (ELISA).The pigs were killed, the heartwere excised and stained with 2, 3, 5-triphenyltetrazolium chloride (TTC). Results6 pig models were successfully established in each group.4 pigs in control group and 3 pigs in tirofiban treating group experienced MO.The MO volume was increased at every time after reperfusion in both groups,while the MO volume was significantly reduced in tirofiban treatment group compared with control group at 1 h [(9.6 ± 3.1) ％ vs.(4.8 ±0.7)％],24 h[(13.4±3.3) ％ vs.(5.8±-1.2)％],48 h[(15.1±3.8)％ vs.(6.4±1.2)％] and 72 h [(15.9±4.6) ％ vs.(6.6±0.8)％ after reperfusion (t=6.99,13.76,14.21,11.38,all P＜0.05).Compared with the baseline,the levels of serum IL-6 and IL-10 in both groups were increased at 30 min after AMI.In tirofiban treatment group,the level of serum IL-6 was significantly lower and serum IL-10 was higher than those in control group (P＜0.05 and P＜0.01) from 10 min to 72 h after reperfusion. Conclusions Tirofiban may lessen the MO area in infarction zone of AMI after reperfusion,which may be ascribed to its anti-inflammation besides anti-platelets.

Objective To evaluate the effcets of tirofihan on myocardial no-reflow after acute myocardial infarction and reperfusion by delayed enhancement-multi-slice CT(DE-MSCT).Methods Chinese mini pigs were randomized into control group and firofiban treatment group. Acute myocardial infarction was induced by balloon occlusion of the medium segment of the left anterior descending artery for 90 minutes. Repeffusion was created by withdrawing the balloon during angiography. All successful models received DE-MSCT examinatons at 1 h, 24 h, 48 h, and 72 h after reperfusion to observe the myocardial noreflow area. Data were analyzed with Spearman rank correlation and Wilcoxon Rank Sum test. Results Six pigs were successfully induced as acute reperfusion myocardial infarction in each group. Furthermore,4 pigs in control group and 3 pigs in firofiban treatment group had no-reflow phenomenon. The no-reflow volume percent increased from 1 h to 72 h in both groups. The no-reflow volume percent was significantly reduced in tirofiban treatment group compared with control group after reperfusion at 1 h, 24 h, 48 h and 72 h respectively[(4.78±0.66)% and (9.62±3.05)%, t =6.000, P＜0.05; (5.84 ± 1.19)% and (13.44±3.33)% ,t=6.000,P＜0. 05;(6.41± 1.24)% and (15.10±3.76)%,t =6.000,P ＜0.05;(6.63 ±0. 82)% and (15.94 ±4.62)% ,t =6.000,P ＜0.05] ,as well as the infarct myocardium volume percent was significantly reduced in tirofiban treatment group compared with control group at 24 h, 48 h and 72 h after reperfusion [ (19.74± 2. 94) % and ( 25.08 ± 4.68) %, t = 25.000, P ＜ 0.05;(20.34±2.46) % and (27.07 ±5.44)%, t =26. 000,P ＜0.05; (20.72 ±2.10)% and (26.17 ±5.19)% ,t = 24.000,P ＜0.05]. Conclusions DE-MSCT can be used to detect the extent of no-reflow phenomenon. Tirofiban can reduce the volume of myocardial infarct and no-reflow area after reperfusion.

Objective: To investigate the relationship between qi and blood quantity in the twelve meridians and musculature,and enrich the theory of meridian doctrine.Methods: By summarizing classic literatures on qi and blood quantity in the twelve meridians and musculature,and combining with clinical practice,the relationship between qi and blood quantity in the twelve meridians and musculature was analyzed and the directive effect of qi and blood quantity in the twelve meridians on diseases of musculature was investigated.Results: Qi and blood in the twelve meridians moisten and nourish the musculature,on the other hand,the musculature also influence the quality of qi and blood.Conclusion: Treatment for diseases of musculature with acupuncture and moxibustion can be perfected by the theory of qi and blood quantity in the twelve meridians,then,the curative effect can also be improved.