Adjuvants as essential ingredients amplify the magnitude and durability of immune responses in various vaccine strategies. Polysaccharides with potent immunoenhancing effects are widely applied as promising vaccine adjuvants, however, they have rarely been licensed for use in human vaccines due to the limitation of their efficacy and safety. Moreover, nanoparticles not only act as antigen drug delivery vectors but also possess intrinsic adjuvant functions, revealing the dual effects of nanoparticles in augmenting antigen-specific immune responses. Intriguingly, nanoparticle forms can enhance the immunostimulatory potency of polysaccharide adjuvants, since polysaccharide nanoparticles exert more excellent adjuvant effects than polysaccharides in initiating humoral, cellular and mucosal immune responses. Emerging evidence has also suggested that multiple immune-related signaling pathways including cGAS-STING, NLRP3, TLRs, cell death or metabolism signaling probably participate in the immunomodulation of polysaccharide nanoparticles, but systemic investigations into the adjuvant mechanism are still inadequate. This review aims to give an updated summary and discussion on the adjuvant function and mechanism of polysaccharide nanoparticles for understanding their superior adjuvant property and effectively utilizing them as potent immune adjuvants in vaccine development.

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 investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and 24-h urinary calcium excretion (24-h UCaE) and hypercalciuria in Chinese adults.Methods:This cross-sectional study was conducted from March 2022 to March 2023 in nine cities in China and included 1 239 residents. Demographic characteristics were collected through questionnaires and physical examinations, fasting blood samples were assessed for bone metabolism indicators, and 24-h urine samples were used to determine the 24-h UCaE. Multiple linear regression analysis was used to explore the relationship between serum 25(OH)D and 24-h UCaE and bone metabolism indexes. The relationship between serum 25(OH)D and hypercalciuria was analyzed using a multiple logistic regression model combined with restricted cubic spline modeling.Results:The mean participant age was (47.9±18.1) years, of which 453 (36.6%) were male. The percentages of vitamin D sufficiency, insufficiency, and deficiency were 7.6% (94/1 239), 29.0% (359/1 239), and 63.4% (786/1 239), respectively. The multiple linear regression model showed that after adjusting for the covariates the 24-h UCaE gradually increased with higher levels of 25(OH)D ( P overall <0.001, P nonlinear <0.001). The logistic regression analysis revealed that compared with the vitamin D deficient group, the OR for the prevalence of hypercalciuria in the vitamin D sufficient and vitamin D insufficient groups were 3.290 (95% CI 1.745 to 6.202) and 3.742 (95% CI 2.458 to 5.697), respectively. The results of the restricted cubic spline modeling showed a positive nonlinear relationship between 25(OH)D and the prevalence of hypercalciuria ( P overall <0.001, P nonlinear <0.001). The prevalence of hypercalciuria increased when 25(OH)D was >17.00 μg/L and peaked at 26.71 μg/L, after which there was a decreasing trend in the prevalence of hypercalciuria with increasing 25(OH)D. Conclusion:Associations between serum 25(OH)D levels and urinary calcium excretion and the prevalence of hypercalciuria were observed in the Chinese adult population.

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 investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and 24-h urinary calcium excretion (24-h UCaE) and hypercalciuria in Chinese adults.Methods:This cross-sectional study was conducted from March 2022 to March 2023 in nine cities in China and included 1 239 residents. Demographic characteristics were collected through questionnaires and physical examinations, fasting blood samples were assessed for bone metabolism indicators, and 24-h urine samples were used to determine the 24-h UCaE. Multiple linear regression analysis was used to explore the relationship between serum 25(OH)D and 24-h UCaE and bone metabolism indexes. The relationship between serum 25(OH)D and hypercalciuria was analyzed using a multiple logistic regression model combined with restricted cubic spline modeling.Results:The mean participant age was (47.9±18.1) years, of which 453 (36.6%) were male. The percentages of vitamin D sufficiency, insufficiency, and deficiency were 7.6% (94/1 239), 29.0% (359/1 239), and 63.4% (786/1 239), respectively. The multiple linear regression model showed that after adjusting for the covariates the 24-h UCaE gradually increased with higher levels of 25(OH)D ( P overall <0.001, P nonlinear <0.001). The logistic regression analysis revealed that compared with the vitamin D deficient group, the OR for the prevalence of hypercalciuria in the vitamin D sufficient and vitamin D insufficient groups were 3.290 (95% CI 1.745 to 6.202) and 3.742 (95% CI 2.458 to 5.697), respectively. The results of the restricted cubic spline modeling showed a positive nonlinear relationship between 25(OH)D and the prevalence of hypercalciuria ( P overall <0.001, P nonlinear <0.001). The prevalence of hypercalciuria increased when 25(OH)D was >17.00 μg/L and peaked at 26.71 μg/L, after which there was a decreasing trend in the prevalence of hypercalciuria with increasing 25(OH)D. Conclusion:Associations between serum 25(OH)D levels and urinary calcium excretion and the prevalence of hypercalciuria were observed in the Chinese adult population.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.

Objective:To explore the establishment of a Cox proportional hazard prediction model for the re-cent(within a week)delivery of pregnant women with threatened early preterm labor(28-33+6 weeks).Meth-ods:The clinical data of 293 patients with threatened early preterm labor at 28-33+6 weeks admitted to the De-partment of Obstetrics,Affiliated Hospital of North Sichuan Medical College from January 2021 to December 2022 were retrospectively collected.According to whether the patient gave birth recently(within a week)during hospi-talization,they were divided into delivery group(n=88)and non-delivery group(n=205).Demographic data,specialty conditions and clinical biochemical indicators were collected,and the differences of each observation in-dex between the two groups were compared.Cox multivariate analysis was used to screen variables,and then the Cox proportional hazard prediction model was constructed to calculate the hazard ratio(HR).The C-index was used to test the predictive ability of the model,and the nomogram was drawn to visualize the Cox proportional hazard prediction model.The calibration curve was used to test the consistency between the model prediction re-sults and the actual situation.Results:The average age of the delivery group was 30.2±5.0 years old,and the average prolonged pregnancy time was 61.3±47.5 hours.Compared to the group that gave birth and did not give birth,the proportion of patients with body mass index(BMI)at admission,parity＞1,gestational diabetes mellitus or diabetic pregnancy combined(GDM/PGDM),abnormal fetal orientation,regular contractions at admis-sion,vaginal cleanliness≥ Ⅲ,white blood cell count ≥10 ×109/L at admission and cervical length＜20 mm,the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis:BMI＞30 kg/m2(HR 2.178,95％CI 1.208-3.928,P=0.010),parity＞1(HR 3.095,95％CI 1.759-5.447,P＜0.001),regular uterine contraction(HR3.447,95％CI 2.216-5.362,P＜0.001),cervical length＜20 mm(HR3.594,95％CI 2.289-5.646,P＜0.001)and white blood cell count≥10 ×109/L(HR2.124,95％CI 1.352-3.335,P=0.001)on admission were independent risk factors for recent(within a week)delivery of pregnant women with threatened early preterm birth.When the above 5 indicators were included in the prediction model,the C-index was 0.797(95％CI 0.750-0.844),indicating that the model had good prediction ability.The calibration chart shows that the prediction results of the model are in good agreement with the actual results.Conclusions:Preg-nant women with BMI＞30 kg/m2 at admission,parity＞1,regular uterine contraction at admission,cervical length＜20 mm at admission and white blood cell count≥10 ×109/L at admission are prone to premature delivery in the near future.Cox proportional risk prediction model based on the above risk factors has certain accuracy,which can be used to guide clinical workers to take corresponding intervention measures in advance to avoid or reduce the possibility of premature delivery in the near future and improve maternal and infant outcomes.