Objective To investigate the efficacy of traditional Chinese medicine in the treatment of multiple system atrophy and orthostatic hypotension. Method The patients with multiple system atrophy and orthostatic hypotension who attended the outpatient service were enrolled and treated with a self-made prescription， Tiaoxin Zhengya Decoction， and their treatment outcome was observed. Result After taking the medication， the patients showed a trend of increase in systolic pressure and a trend of stability or reduction in diastolic pressure. The patients showed significant changes in diastolic pressure in the supine position， systolic pressure in the supine position， diastolic pressure in the sitting position， systolic pressure in the sitting position， and systolic pressure in the standing position after getting up in the morning， while there were no differences when they went to bed at night. Conclusion Traditional Chinese medicine has good efficacy in the treatment of multiple system atrophy and orthostatic hypotension.

Objective: To construct a scientific and perfect evaluation index system of infectious disease prevention and control ability in colleges and universities, so as to provide reference tools for colleges and universities to effectively respond to infectious disease. Methods: The initial framework of the evaluation index system of infectious disease prevention and control ability in colleges and universities was constructed by using literature analysis method. Experts familiar with infectious disease prevention and control or school health work were selected to conduct two rounds( n =16，18) of Delphi expert consultation for determining the evaluation index system. Analytical hierarchy process was used to calculate the index weights and combined weights. About 198 prevention and control personnel were conveniently selected from 3 universities in Inner Mongolia Autonomous Region to comprehensively evaluate the evaluation indicators by using fuzzy comprehensive evaluation method. Results: After two rounds of Delphi consultation questionnaire, the effective recovery rates were 80.0% and 90.0%, the expert authority levels were 0.89 and 0.86, the expert harmony coefficients for Kendall W were 0.166 and 0.310, and the variation coefficient of each index was <0.25. Finally, the evaluation index system of infectious disease prevention and control ability of colleges and universities included 4 first level indicators, 14 second level indicators and 75 third level indicators. The weights of prevention and monitoring and early warning, organizational system guarantee, emergency management, rehabilitation and summary were 0.176, 0.476, 0.268 and 0.080, respectively. The top 3 weights of the secondary indexes were 0.623 for infectious disease surveillance and early warning, 0.595 for loss assessment and 0.370 for emergency response. The score of fuzzy comprehensive evaluation of the index system of infectious disease prevention and control ability in colleges and universities was 79.148, suggesting a high level. Conclusion The established evaluation index system of infectious disease prevention and control ability in colleges and universities is scientific and reasonable, which is conducive to provide tool reference for the evaluation of infectious disease prevention and control ability in colleges and universities.

Objective Using the Traditional Chinese Medicine Inheritance Assistance Platform V2.5 software,to analyze medical cases and prescription medication patterns of multiple system atrophy-orthostatic hypotension,and provide reference for clinical diagnosis and treatment of multiple system atrophy.Methods Relevant literature on the effectiveness of traditional Chinese medicine in treating multiple system atrophy-orthostatic hypotension was collected from China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP,Chinese Medical Journal Full Text Database,and China Biomedical Literature Database.A database of medical cases and prescriptions was established on the Traditional Chinese Medicine Inheritance Assistance Platform.The software used mathematical algorithms based on association rules and entropy clustering to analyze the symptom ranking,symptom patterns,symptom clustering,and network display of medical cases,as well as the properties,taste,meridian tropism,frequency of application,and drug pair combinations of drugs in prescriptions.The core drugs were identified and the rules of diagnosis and treatment were explored.Results Through the Traditional Chinese Medicine Inheritance Assistance Platform V2.5 software,47 medical cases of multiple system atrophy were analyzed,including 73 symptoms.Among them,there were 8 symptoms with a frequency of ≥5,among which the most frequent symptom was pulse sinking,which appeared 8 times.And included 11 syndromes,the most frequent symptom was insufficient Qi syndrome,which appeared 12 times.The drug symptom network diagram,drug symptom network diagram,and drug symptom network diagram of multiple system atrophy-orthostatic hypotension medical cases were also drawn,which is the first time in the study.There are a total of 47 prescriptions for multiple system atrophy,including 106 types of drugs.Through analysis,the drugs used are mainly warm,cold,and flat,with less use of hot and cool drugs.The flavors are mainly sweet,spicy,and bitter,and the meridian tropism is mainly focused on the spleen,lungs,liver,heart,kidneys,and stomach.The top 10 drugs with the highest frequency of occurrence are Huangqi,Danggui,Shengma,Baizhu,Dangshen,Chenpi,Renshen,Chaihu,Fuzi,and Zhigancao.Among them,Huangqi has the highest frequency of occurrence,appearing 31 times,and has evolved into 66 core combinations of drugs and 3 new formulas.Conclusion The objective display of the medical case characteristics and medication features of multiple system atrophy-orthostatic hypotension through data mining has certain guiding significance for the research and clinical medication of this disease.

Objective Two-sample Mendelian randomization(MR)analysis was used to explore the causal relationship between hyperthyroidism/hypothyroidism and insomnia.Methods A two-sample MR method was adopted.The exposure factors were hyperthyroidism/hypothyroidism,and the outcome was insomnia.The instrumental variables were screened.Inverse variance weighting(IVW)was mainly used to analyze the causal relationship between hyperthyroidism/hypothyroidism and insomnia.Meanwhile,MR-Egger,weighted mode,weighted median,and simple mode were used to supplement the IVW analysis results.Cochran's Q test was used to determine the statistical heterogeneity among single nucleotide polymorphism(SNP),and the intercept term of MR-Egger was used to evaluate whether SNP had horizontal pleomorphism.The influence of a single SNP on the IVW analysis results was evaluated by the retention of one method.To avoid reverse causality,insomnia was taken as the exposure factor and hyperthyroidism/hypothyroidism as the outcome event for reverse MR analysis.Results A total of 11 SNP strongly related to hyperthyroidism were screened out.After eliminating the palindromic sequences,9 SNP strongly related to hyperthyroidism were finally included.The IVW analysis results showed that hyperthyroidism increased the risk of insomnia(OR=1.01,95％CI:1.00-1.01,P=0.012).A total of 68 SNP strongly related to hypothyroidism were screened out.After removing the palindromic sequences,61 SNP highly related to hypothyroidism were finally included.The IVW analysis results showed that hypothyroidism increased the risk of insomnia(OR=1.01,95％CI:1.00-1.01,P=0.021).The results of Cochran's Q test showed that there was no heterogeneity in the instrumental variable hyperthyroidism(P=0.60).The MR-Egger intercept analysis indicated that studies with hyperthyroidism/hypothyroidism as exposure and insomnia as the outcome did not have horizontal pleiotropy(P＞0.05).Reverse MR analysis revealed that exposure factors such as insomnia had no causal relationship with hyperthyroidism(OR=1.57,95％CI:0.55-4.50,P=0.40)or hypothyroidism(OR=1.09,95％CI:0.74-1.61,P=0.66).Conclusion Hyperthyroidism/hypothyroidism can increase the risk of insomnia.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

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 analyze the intercomparision result of personal dose monitoring and gross alpha/beta detection capability between the disease control and prevention institutions at provincial, municpal and county levels during 2022-2024, in order to provide a reference for radiation detection capability and policy making of these institutions in China.Methods:Data on personal dose monitoring and gross alpha/beta detection, obtanied from the 2022-2024 radiation detection capability intercomparison between the disease control and prevention institutions at different levels, were recorded. Both the qualification rates (including excellence) and excellence rates of all the institutions at all evels from 2022 to 2024 were analyzed using SPSS 22.0.Results:From 2022 to 2024, the number of participating institutions at all levels showed an overall upward trend, increasing from 262 to 430, with particularly notable growth at the municipal level. In the 2024 gross α/β detection capability intercomparison, the non-qualification rate in municipal-level institutions was significantly higher than in county-level institutions ( χ2=10.53, P < 0.05). The qualification rate (including excellence) of the municipal-level gross alpha/beta detection in 2022 and 2024 were lower than in 2023( χ2=29.93, P < 0.01). Among all regions, the 2024 personal dose monitoring intercomparison result showed that the qualification rate (including excellence) in East China was higher than in Southwest and Northwest China ( χ2=15.62, P <0.01). East China also outperformed Northwest China ( χ2=16.21, P <0.01). In the 2022 gross alpha/beta detection capability intercomparison, the qualification rate (including excellent performance) in East China and South China was higher than in Northwest China ( χ2=23.76, 11.22, P<0.01). Overall, East China showed relatively higher qualification rate in intercomparison result of both personal dose monitoring and radiation detection (including excellence), while Northwest China showed lower qualification rates (including excellence). Conclusions:Although the radiation detection capability of disease control and prevention institutions at all levels has improved in recent years, there are still insufficience of detection capabilities at some municipal- and county-level laboratories and even unbalance between different regionas. Policy support should prioritize underdeveloped areas, such as municipal- and county-level institutions and the Northwest, and enhance the technical proficiency and quality management of laboratory personnel.

Esophageal cancer is the eighth most common malignant tumor in the world, and China is a country with high incidence of esophageal cancer. Currently, The treatment options for resectable esophageal cancer is multidisciplinary comprehensive treatment based on surgery. In recent years, minimally invasive esophageal cancer surgery has been increasingly used in clinical practice, especially McKeown minimally invasive esophagectomy(MIE) has become the most minimally invasive esophagectomy currently used in China. But how effective is the McKeown MIE for esophageal cancer compared to the open McKeown and other minimally invasive esophageal cancer procedures? A detailed comprehensive description is not yet available. In this paper, We will summarize the clinical studies related to McKeown MIE and traditional open McKeown, Ivor-Lewis MIE, Sweet operation and robot-assisted McKeown MIE, and systematically analyze them, so as to clarify the value of McKeown MIE surgery in the treatment of esophageal cancer.

Objective:To summarize the surgical strategies and to evaluate the clinical outcomes of up-per urinary tract reconstruction in patients with stone-related ureteral strictures.Methods:This retro-spective study included 71 patients diagnosed with ureteral strictures secondary to urinary stones who un-derwent upper urinary tract reconstructive surgery at Peking University First Hospital between March 2014 and November 2023.Patient data were collected,including demographic characteristics,clinical presen-tation,laboratory results,imaging findings,surgical procedures,and follow-up outcomes.Ureteral stric-tures were classified according to anatomical location into upper,middle,lower,or multiple segments.Surgical procedures were carried out depending on the stricture characteristics.Surgical success was de-fined as resolution or improvement of clinical symptoms,radiographic improvement or stabilization of hy-dronephrosis,and maintenance of normal and stable renal function.Results:Among the 71 patients,36(50.7％)had strictures in the upper ureter,9(12.7％)in the middle ureter,15(21.1％)in the lower ureter,and 11(15.5％)had multifocal ureteral strictures.The median stricture length was 5.0 cm(interquartile range:3.0-15.0 cm).Surgical approach selection was individualized based on the location and extent of the stricture.For upper ureteral strictures,the most frequently employed techniques were oral mucosal graft ureteroplasty(13/36,36.1％)and appendiceal flap ureteroplasty(8/36,22.2％).Other options included ureteroureterostomy and ileal ureter replacement for longer or more complex strictures.In middle ureteral strictures,treatment was stratified by length:balloon dilation(1/9,11.1％)and ureteroureterostomy(1/9,11.1％)were applied in shorter strictures,while oral mucosal graft ureteroplasty(3/9,33.3％)and ileal ureter replacement(4/9,44.4％)were reserved for longer segments.For lower ureteral strictures,ureteral reimplantation into the bladder was the most common approach(10/15,66.7％),often combined with a psoas hitch or Boari flap when necessary.All the patients with multiple segmental strictures underwent ileal ureter replacement due to the extensive nature of the disease.The median follow-up period was 14.2 months(range:6.1-107.1 months).During follow-up,69 of 71 patients(97.2％)achieved surgical success.Conclusion:Stone-related ure-teral strictures present with considerable heterogeneity in terms of anatomical location,length,and com-plexity.Careful preoperative evaluation and individualized surgical planning are critical to successful re-construction.With appropriate selection of surgical methods,favorable long-term clinical outcomes can be achieved in the majority of patients.