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.

Infectious diseases of the respiratory system are very common in clinical practice,among which pneumonia caused by in-fluenza virus infection is characterized by high morbidity and mortality.Current clinical treatments for respiratory viral infections still face challenges such as drug resistance and poor efficacy.Necroptosis,a form of programmed cell death,is closely associated with the progression of respiratory viral infections.Traditional Chinese medicine modulating necroptosis has demonstrated beneficial therapeu-tic effects in these diseases.This paper introduces the concept and mechanisms of necroptosis,reviews recent research on the relation-ship between necroptosis and respiratory virus infections diseases,and summarizes the therapeutic effects of traditional Chinese medi-cine in regulating necroptosis to intervene in these diseases,aiming to provide insights for the development and clinical application of therapeutic agents for respiratory viral infections.

Infectious diseases of the respiratory system are very common in clinical practice,among which pneumonia caused by in-fluenza virus infection is characterized by high morbidity and mortality.Current clinical treatments for respiratory viral infections still face challenges such as drug resistance and poor efficacy.Necroptosis,a form of programmed cell death,is closely associated with the progression of respiratory viral infections.Traditional Chinese medicine modulating necroptosis has demonstrated beneficial therapeu-tic effects in these diseases.This paper introduces the concept and mechanisms of necroptosis,reviews recent research on the relation-ship between necroptosis and respiratory virus infections diseases,and summarizes the therapeutic effects of traditional Chinese medi-cine in regulating necroptosis to intervene in these diseases,aiming to provide insights for the development and clinical application of therapeutic agents for respiratory viral infections.

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.

This study was performed to investigate the therapeutic effect of oroxylin A(OA)on chicken type Ⅱcollagen-induced arthritis(CIA)in mice and observe the changes of immune cells.The CIA model was established,and 40 mg/kg OA was intraperitoneally injected for 10 consecutive days from the 28th day.The mice were sacrificed at three different times during the administration period,and the joints were scored at each time point.HE staining was used to observe the pathology of the mouse ankle joint;flow cytometry was used to detect the changes of Th17,Treg and macrophages in spleen and inguinal lymph nodes;ELISA was employed to detect the expression levels of IL-1β,IL-18 and IL-6 in serum;and qRT-PCR was used to detect the expression levels of IL-1β,IL-18,IL-6 and TNF-β in spleen of mice.Data showed that on the 34th day after OA administration,the joint swelling of CIA mice was significantly relieved,the pathological score was decreased,and the inflammatory cell infiltration was decreased.Flow cytometry results showed that the proportion of Th17 cells and macrophages in the spleen and inguinal lymph nodes of CIA mice in OA group decreased,while the proportion of Treg cells increased.The results of ELISA and qRT-PCR showed that OA could inhibit the level of inflammation in CIA mice.In conclusion,OA can regulate the proportion of immune cells,inhibit the level of inflammation in CIA mice,and then relieve the symptoms of CIA mice.

With the frequent occurrence of respiratory viral infectious diseases,global public health is facing major challenges,and finding effective prevention and treatment methods has become a top priority.As an important part of traditional Chinese medicine,Chinese medicine has shown unique advantages in antiviral treatment.This article aims to review the modern scientific research pro-gress of Chinese medicine against respiratory viral infectious diseases,explore its advantages in clinical application and how to deeply understand the scientific connotation of Chinese medicine intervention in the whole-life cycle of viruses through multidisciplinary cross-integration,and systematically analyze the research strategy of the antiviral infection mechanism of Chinese medicine compound.It pro-vides a reference for the reserve of candidate Chinese medicine for future prevention and control of virus safety risks,which is of great significance for effectively supporting the prevention,control and treatment of new and emerging viral infectious diseases in China.

Total hip arthroplasty(THA)is an effective treatment for elderly femoral neck fractures,mid-to late-stage femoral head necrosis,and end-stage hip osteoarthritis.However,serious complications such as aseptic loosening of the prosthesis,peripheral fractures,and dislocation of the prosthesis still exist following THA,which makes the selection of the appropriate hip prosthesis type and placement position before THA an important challenge for surgeons.Currently,the commonly used preoperative planning methods for THA mainly rely on static images from two-dimensional(2D)X-ray or three-dimensional(3D)computed tomography(CT),which fail to adequately consider the hip joint in weight-bearing as well as motion,lumbar-hip joint changes,and prosthetic impingement during motion.Recently,the dual fluoroscopic imaging system,as a new in-vivo,dynamic radiological imaging technology,provides comprehensive and accurate dynamic 3D data for THA preoperative planning.However,the technical process and expert consensus on preoperative 3D planning of THA using a dual fluoroscopic imaging system have not yet been established,which affects the promotion and application of this technology.In light of the above,national orthopaedic experts and related professional representatives discussed and proposed seven consensus issues,and the'expert recommendation rate'and'strong recommendation rate'were obtained through a questionnaire survey on the recommendations of the participating experts.This consensus aims to provide guidance and reference for the standardised application of preoperative 3D planning of THA using the dual fluoroscopic imaging system.

Total hip arthroplasty(THA)is an effective treatment for elderly femoral neck fractures,mid-to late-stage femoral head necrosis,and end-stage hip osteoarthritis.However,serious complications such as aseptic loosening of the prosthesis,peripheral fractures,and dislocation of the prosthesis still exist following THA,which makes the selection of the appropriate hip prosthesis type and placement position before THA an important challenge for surgeons.Currently,the commonly used preoperative planning methods for THA mainly rely on static images from two-dimensional(2D)X-ray or three-dimensional(3D)computed tomography(CT),which fail to adequately consider the hip joint in weight-bearing as well as motion,lumbar-hip joint changes,and prosthetic impingement during motion.Recently,the dual fluoroscopic imaging system,as a new in-vivo,dynamic radiological imaging technology,provides comprehensive and accurate dynamic 3D data for THA preoperative planning.However,the technical process and expert consensus on preoperative 3D planning of THA using a dual fluoroscopic imaging system have not yet been established,which affects the promotion and application of this technology.In light of the above,national orthopaedic experts and related professional representatives discussed and proposed seven consensus issues,and the'expert recommendation rate'and'strong recommendation rate'were obtained through a questionnaire survey on the recommendations of the participating experts.This consensus aims to provide guidance and reference for the standardised application of preoperative 3D planning of THA using the dual fluoroscopic imaging system.

BACKGROUND: Previous evidence suggests inflammation may be a double-edged sword with cancer-promoting and cancer suppressing function. In this study, we explore the impact of local and systemic inflammation on cancer growth. METHODS: Female BALB/C mice were subcutaneously implanted with foreign body (plastic plates) to build up a local inflammation and intraperitoneally injected with PolyIC or lipopolysaccharides (LPS) to build up a systemic inflammation, followed by subcutaneous injection of 5  × 10 5 colon cancer cells. Immunohistochemistry and enzyme linked immunosorbent assay were utilized to detect the Ki67 and interleukin (IL) 6, IL-1β, and monocyte chemoattractant protein-1 expression in the tumor tissues and serum, respectively. The distributions of immune cells and expression of toll-like receptors (TLRs) were evaluated by flow cytometry (FCM) and quantitative real time-polymerase chain reaction. RESULTS: The results showed that local inflammation induced by foreign body implantation suppressed tumor growth with decreased tumor weight ( P   =  0.001), volume ( P   =  0.004) and Ki67 index ( P   <  0.001). Compared with the control group, myeloid-derived suppressive cells sharply decreased ( P   =  0.040), while CD4 + T cells slightly increased in the tumor tissues of the group of foreign body-induced local inflammation ( P   =  0.035). Moreover, the number of M1 macrophages ( P   =  0.040) and expression of TLRs, especially TLR3 ( P  < 0.001) and TLR4 ( P  < 0.001), were significantly up-regulated in the foreign body group. Contrarily, tumor growth was significantly promoted in LPS or PolyIC-induced systemic inflammation ( P   =  0.009 and 0.006). FCM results showed M1 type macrophages ( P   =  0.017 and 0.006) and CD8 + T cells ( P   =  0.031 and 0.023) were decreased, while M2 type macrophages ( P  = 0.002 and 0.007) were significantly increased in tumor microenvironment of LPS or PolyIC-induced systemic inflammation group. In addition, the decreased expression of TLRs was detected in LPS or PolyIC group. CONCLUSIONS The foreign body-induced local inflammation inhibited tumor growth, while LPS or PolyIC- induced systemic inflammation promoted tumor growth. The results suggested that the different outcomes of tumor growth might be attributed to the infiltration of anti-tumor or pro-tumor immune cells, especially M1 or M2 type macrophages into tumor microenvironment.
Animals ; Chemokine CCL2/metabolism* ; Cytokines/metabolism* ; Female ; Foreign Bodies ; Inflammation/metabolism* ; Interleukin-6/metabolism* ; Ki-67 Antigen/metabolism* ; Lipopolysaccharides/pharmacology* ; Macrophages/metabolism* ; Mice ; Mice, Inbred BALB C ; Neoplasms/metabolism* ; Plastics/metabolism* ; Toll-Like Receptor 3/metabolism* ; Toll-Like Receptor 4/metabolism* ; Tumor Microenvironment

The medical fungus Hirsutella sinensis has been used as a Chinese folk health supplement because of its immunomodulatory properties. Our previous studies established the antifibrotic action of Hirsutella sinensis mycelium (HSM) in the lung. The epithelial-mesenchymal transition (EMT) is involved in the pathogenesis of idiopathic pulmonary fibrosis. The present study investigates the role of HSM in mediating EMT during the development of pulmonary fibrosis. HSM significantly inhibits bleomycin (BLM)-induced pulmonary fibrosis by blocking the EMT. In addition, the expression levels of midkine are increased in the lungs of the BLM-induced group. Further analysis of the results indicates that the mRNA level of midkine correlated positively with EMT. HSM markedly abrogates the transforming growth factor β-induced EMT-like phenotype and behavior in vitro. The activation of midkine related signaling pathway is ameliorated following HSM treatment, whereas this extract also caused an effective attenuation of the induction of EMT (caused by midkine overexpression) in vitro. Results further confirm that oral medication of HSM disrupted the midkine pathway in vivo. Overall, findings suggest that the midkine pathway and the regulation of the EMT may be considered novel candidate therapeutic targets for the antifibrotic effects caused by HSM.
Bleomycin ; Epithelial-Mesenchymal Transition ; Humans ; Midkine ; Mycelium ; Pulmonary Fibrosis/drug therapy*