Objective:To evaluate the effect of continuous theta burst stimulation (cTBS) on postoperative cognitive dysfunction (POCD) in mice and its association with the excitability of parvalbumin (PV) neurons in the medial prefrontal cortex (mPFC).Methods:Twenty-four specific pathogen-free healthy male C57BL/6 mice, aged 8 weeks, weighing 18-24 g, in which adeno-associated virus (AAV) for labeling PV neurons was injected into the mPFC using stereotaxic surgery, were used in this study. Three weeks later, the mice were divided into 3 groups ( n=8 each) using a random number table method: control group (group C), POCD group (group P) and cTBS group. Group C received no treatment. A mouse model of POCD was established by performing tibial fracture surgery under sevoflurane anesthesia and the mice received sham stimulation from postoperative day 0 to day 4 in group P. Group cTBS underwent POCD model establishment and received cTBS stimulation from postoperative day 0 to day 4. Cognitive function was assessed using contextual fear conditioning, Y-maze and novel object recognition tests on postoperative day 5. The spontaneous firing frequency of PV neurons in the mPFC was then measured using ex vivo patch-clamp electrophysiology. Results:The results of contextual fear conditioning test showed that compared to group C, the percentage of freezing time was significantly increased in group P ( P<0.05); compared to group P, the percentage of freezing time was significantly decreased in group cTBS ( P<0.05). The results of Y-maze test showed that compared to group C, the alternation accuracy was significantly decreased in group P ( P<0.05); compared to group P, the alternation accuracy was significantly increased in group cTBS ( P<0.05). The results of novel object recognition test showed that compared to group C, the percentage of time spent exploring the novel object was significantly decreased in group P ( P<0.05); compared to group P, this percentage of time spent exploring the novel object was significantly increased in group cTBS ( P<0.05). The results of ex vivo patch-clamp electrophysiology showed that compared to group C, the spontaneous firing frequency of PV neurons in the mPFC was significantly decreased in group P ( P<0.05); compared to group P, the spontaneous firing frequency of PV neurons in the mPFC was significantly increased in group cTBS ( P<0.05). Conclusions:cTBS can ameliorate POCD in mice, and the mechanism is related to the restoration of excitability of PV neurons in the mPFC.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:To evaluate the effect of continuous theta burst stimulation (cTBS) on postoperative cognitive dysfunction (POCD) in mice and its association with the excitability of parvalbumin (PV) neurons in the medial prefrontal cortex (mPFC).Methods:Twenty-four specific pathogen-free healthy male C57BL/6 mice, aged 8 weeks, weighing 18-24 g, in which adeno-associated virus (AAV) for labeling PV neurons was injected into the mPFC using stereotaxic surgery, were used in this study. Three weeks later, the mice were divided into 3 groups ( n=8 each) using a random number table method: control group (group C), POCD group (group P) and cTBS group. Group C received no treatment. A mouse model of POCD was established by performing tibial fracture surgery under sevoflurane anesthesia and the mice received sham stimulation from postoperative day 0 to day 4 in group P. Group cTBS underwent POCD model establishment and received cTBS stimulation from postoperative day 0 to day 4. Cognitive function was assessed using contextual fear conditioning, Y-maze and novel object recognition tests on postoperative day 5. The spontaneous firing frequency of PV neurons in the mPFC was then measured using ex vivo patch-clamp electrophysiology. Results:The results of contextual fear conditioning test showed that compared to group C, the percentage of freezing time was significantly increased in group P ( P<0.05); compared to group P, the percentage of freezing time was significantly decreased in group cTBS ( P<0.05). The results of Y-maze test showed that compared to group C, the alternation accuracy was significantly decreased in group P ( P<0.05); compared to group P, the alternation accuracy was significantly increased in group cTBS ( P<0.05). The results of novel object recognition test showed that compared to group C, the percentage of time spent exploring the novel object was significantly decreased in group P ( P<0.05); compared to group P, this percentage of time spent exploring the novel object was significantly increased in group cTBS ( P<0.05). The results of ex vivo patch-clamp electrophysiology showed that compared to group C, the spontaneous firing frequency of PV neurons in the mPFC was significantly decreased in group P ( P<0.05); compared to group P, the spontaneous firing frequency of PV neurons in the mPFC was significantly increased in group cTBS ( P<0.05). Conclusions:cTBS can ameliorate POCD in mice, and the mechanism is related to the restoration of excitability of PV neurons in the mPFC.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Objective:To evaluate the analgesic efficacy of supra-inguinal fascia iliac compartment block (S-FICB)in patients with hip fracture.Methods:This study was a single-center, randomized controlled trial. Forty-eight patients who were admitted to the emergency department due to clinically diagnosed femoral neck or intertrochanteric fractures from April to September 2023 were selected. A random sequence was generated using IBM SPSS Statistics 20, and the patients were divided into 2 groups in a 1∶1 ratio( n=24 each): S-FICB group and infra-inguinal fascia iliac compartment block (I-FICB) group. Both groups received nerve blocks under ultrasound guidance, with an injection of 0.25% ropivacaine 40 ml. The primary outcome measure was sufentanil consumption within 24 h post-block. Secondary outcome measures included the distribution of local anesthetic spread as observed on CT at 0.5 h post-block, the extent of hip skin sensory reduction to pinprick, the time to first analgesic pump pressing, the number of effective analgesic pump pressing within 24 h post-block, the Numeric Rating Scale (NRS) score for pain during passive movement at 0.5 h post-block, and the static NRS scores at baseline (pre-block) and at 0.5, 3, 6, 12 and 24 h post-block. Results:Compared to I-FICB group, the consumption of sufentanil was significantly decreased, the coverage of lumbar plexus nerve branches by local anesthetics was increased, NRS scores were decreased during passive movement, the time to the first analgesic pump pressing was prolonged, the number of effective pump pressing was reduced, and static NRS scores were decreased at 24 h post-block in S-FICB group( P<0.01). In I-FICB group, no local anesthetic coverage of the iliohypogastric or ilioinguinal nerves was observed. Neither group showed coverage of the obturator nerve by the local anesthetic. Conclusions:Compared to I-FICB, S-FICB (0.25% ropivacaine 40 ml) provides a wider range of local anesthetic spread and can cover more branches of the lumbar plexus, which exerts better analgesic efficacy in patients with hip fracture. However, neither approach directly blocks the obturator nerve.

Objective:To evaluate the analgesic efficacy of supra-inguinal fascia iliac compartment block (S-FICB)in patients with hip fracture.Methods:This study was a single-center, randomized controlled trial. Forty-eight patients who were admitted to the emergency department due to clinically diagnosed femoral neck or intertrochanteric fractures from April to September 2023 were selected. A random sequence was generated using IBM SPSS Statistics 20, and the patients were divided into 2 groups in a 1∶1 ratio( n=24 each): S-FICB group and infra-inguinal fascia iliac compartment block (I-FICB) group. Both groups received nerve blocks under ultrasound guidance, with an injection of 0.25% ropivacaine 40 ml. The primary outcome measure was sufentanil consumption within 24 h post-block. Secondary outcome measures included the distribution of local anesthetic spread as observed on CT at 0.5 h post-block, the extent of hip skin sensory reduction to pinprick, the time to first analgesic pump pressing, the number of effective analgesic pump pressing within 24 h post-block, the Numeric Rating Scale (NRS) score for pain during passive movement at 0.5 h post-block, and the static NRS scores at baseline (pre-block) and at 0.5, 3, 6, 12 and 24 h post-block. Results:Compared to I-FICB group, the consumption of sufentanil was significantly decreased, the coverage of lumbar plexus nerve branches by local anesthetics was increased, NRS scores were decreased during passive movement, the time to the first analgesic pump pressing was prolonged, the number of effective pump pressing was reduced, and static NRS scores were decreased at 24 h post-block in S-FICB group( P<0.01). In I-FICB group, no local anesthetic coverage of the iliohypogastric or ilioinguinal nerves was observed. Neither group showed coverage of the obturator nerve by the local anesthetic. Conclusions:Compared to I-FICB, S-FICB (0.25% ropivacaine 40 ml) provides a wider range of local anesthetic spread and can cover more branches of the lumbar plexus, which exerts better analgesic efficacy in patients with hip fracture. However, neither approach directly blocks the obturator nerve.

Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.

BACKGROUND: Peanut allergy is an increasing problem in Singapore and strict avoidance is difficult as peanut is ubiquitous in Asian cuisine. OBJECTIVE: We aimed to assess the efficacy and safety of peanut oral immunotherapy (OIT) in children with obvious peanut allergy in Singapore. METHODS: This was an open-label study of peanut OIT in children living in Singapore, with 2 weekly dose escalation until final maintenance dose of 3,000 mg of peanut protein and a maintenance phase of 12 months. An oral food challenge was performed at 6 months to assess for desensitisation and at 4 weeks after discontinuation of OIT having completed 12 months of maintenance therapy to assess for possible sustained unresponsiveness. The adverse events were monitored using the symptom diaries. RESULTS: Nine subjects were started on OIT, with 7 managing to complete maintenance phase of therapy. Of these 7, all were able to tolerate at least 3,000 mg of peanut protein by 6 months of maintenance therapy, showing that the OIT was effective. Of these 7, 3 patients complied with the 4-week abstinence period after completion of OIT before another peanut challenge; 2 of the 3 subjects showed a significant decrease from the initial ability to tolerate 3,000 mg of peanut protein. Side effects were mainly gastrointestinal in nature and were more common during the updosing phase than the maintenance phase. No episodes of anaphylaxis were observed in this study. CONCLUSION: Peanut OIT seemed to be effective and safe in our cohort of Singaporean children.
Anaphylaxis ; Arachis ; Asian Continental Ancestry Group ; Child ; Cohort Studies ; Humans ; Hypersensitivity ; Immunotherapy ; Peanut Hypersensitivity ; Pilot Projects ; Probiotics ; Singapore

Researchers subjective emphasis on application for the project,contempt to complete the project.To safeguard the research projects carried out smoothly and successfully completed,improve hospital credibility,the hospital in many ways to strengthen the scientific research project management,such as creating a strong scientific and academic atmosphere,the establishment of preresearch funds,hospital research,enhance service awareness,the establishment of the project evaluation system to strengthen the management of project mid-term and node title,funds management,effectively promoted the development of the hospital research.