Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

ObjectiveTo explore the effect and mechanism of Qigui Didang decoction， formulated based on the principle of Tonifying Deficiency and Unblocking Collaterals， on improving metabolic memory of db/db mice with diabetic nephropathy （DN） through silent information regulator 1 signal regulator 1 （Sirt1）/p53/nuclear factor kappa-B （NF-κB） p65 pathway. MethodsFifteen db/db mice were randomly divided into model group （10 mL·kg^-1·d^-1）， resveratrol group （20 mg·kg^-1·d^-1）， and Qigui Didang decoction group （3.34 g·kg^-1·d^-1） Another five db/m mice were selected as the normal group （10 mL·kg^-1·d^-1）. After the intervention， the kidney weight of each group was measured， and the kidney index （KI） was calculated. Fasting blood glucose （FBG）， creatinine （CRE）， β2-microglobulin （β2-MG）， blood urea nitrogen （BUN）， and cystatin C （CysC） were measured. Renal pathology was observed by hematoxylin-eosin （HE） staining and Masson staining. The mRNA and protein expression levels of Sirt1， NF-κB， tumor suppressor gene p53， interleukin-1β （IL-1β）， and cysteine aspartate protease-3 （Caspase-3） were detected using real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultsCompared with the normal group， the model group showed disordered renal structure， obvious renal damage， and markedly elevated levels of renal function indexes （CRE， β2-MG， BUN， and CysC） （P<0.01）. The KI and blood glucose were significantly increased （P<0.01）， while Sirt1 expression was markedly decreased （P<0.01）. Expression levels of NF-κB p65， p53， IL-1β， and Caspase-3 were increased significantly （P<0.05）. Compared with those in the model group， DN mice treated with Qigui Didang decoction exhibited significantly decreased FBG， improved renal function， and markedly decreased KI （P<0.01）， along with reduced CRE， β2-MG， BUN， and CysC levels （P<0.05）. Protein expression of Sirt1 was significantly upregulated （P<0.05）， while that of NF-κB p65， p53， IL-1β， and Caspase-3 was markedly decreased （P<0.05）. The mRNA expression levels of NF-κB p65， p53， IL-1β， and Caspase-3 were significantly decreased （P<0.05）. The staining results indicate improved renal fibrosis， significantly decreased fiber deposition （P<0.05）， and less inflammatory infiltration in the Qigui Didang decoction group. ConclusionThe findings suggest that Qigui Didang decoction can alleviate the metabolic memory effect of DN， thereby inhibiting renal cell apoptosis and inflammatory response in mice， and improving renal function. The mechanism of action is closely related to the Sirt1/p53/NF-κB p65 signaling pathway.

BackgroundPrevious studies have identified a close relationship among psychological neglect and abuse， negative affect， different stages of adolescence， and suicidal ideation. However， the mechanisms underlying the impact of psychological abuse and neglect on suicidal ideation among left-behind adolescents remain unclear， and this field of research is still in its relative infancy. ObjectiveTo explore the relationship between psychological neglect/abuse and suicidal ideation among left-behind adolescents， as well as the mediating role of negative affect and the moderating effect of different stages of adolescence， so as to provide insights for preventing and intervening suicidal ideation in this population. MethodsFrom November 2021 to May 2022， a cluster random sampling technique was utilized to select 2 309 left-behind adolescents in western China. Assessments were conducted using the Child Psychological Abuse and Neglect Scale （CPANS）， the Positive and Negative Suicide Ideation （PANSI） and the Positive and Negative Affect Schedule for Children （PANAS-C）. Spearman correlation coefficients were calculated across all samples， and Process 4.1 was employed to test the mediating role of negative affect and the moderating role of different stages of adolescence in the pathway linking psychological abuse/neglect to suicidal ideation. ResultsA total of 2 119 left-behind adolescents （mean age： 14.94±1.20 years） completed the study， with males comprising 51.34% （1 088/2 119） and females 48.66% （1 031/2 119）.Among left-behind adolescents， scores on CPANS psychological neglect subscale showed positive correlations with both psychological abuse subscale scores and PANAS-C negative affect subscale scores （r=0.446， 0.496， P<0.01）. Additionally， CPANS psychological neglect and psychological abuse subscale scores were also positively correlated with PANSI scores （r=0.487， 0.508， P<0.01）. Furthermore， PANAS-C negative affect subscale scores demonstrated a positive correlation with PANSI scores （r=0.499， P<0.01）. Negative affect partially mediated the relationship between psychological abuse/psychological neglect and suicidal ideation， with effect sizes of 0.166 （95% CI： 0.141~0.191） and 0.131 （95% CI： 0.112~0.152）. Different stages of adolescence moderated the latter part （negative emotion → suicidal ideation） of the indirect mediation path from psychological neglect to suicidal ideation through negative affect （β=-0.066， P<0.01）. ConclusionBoth psychological neglect and psychological abuse may influence suicidal ideation among left-behind adolescents via negative affect. Moreover， different stages of adolescence may moderate the indirect path from psychological neglect to suicide ideation through negative affect.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective To investigate the prenatal diagnosis and perinatal outcomes between anterior pla-centa accreta and non-anterior placenta.Methods A retrospective analysis was done for 560 pregnant women who were diagnosed with placenta accreta and delivered in the Third Affiliated Hospital of Guangzhou Medical Uni-versity.According to the location of the placenta,the group was dividing into anterior placenta accreta group(319 cases)and non-anterior placenta accreta group(241 cases).The general characteristics,maternal and infant out-comes of the two groups were analyzed.The non-anterior placenta accrete group(241 cases)then were dividing into two groups according to the time of clear diagnosis.Those who were firstly diagnosed with placenta accrete dur-ing or after the operation was the intrapartum diagnosis group(missed diagnosis)(70 cases),and those who were diagnosed with clear placenta accreta before the delivery was prenatal diagnosis group(171 cases).The general characteristics,maternal and infant outcomes of the two groups were also analyzed.Results There were statisti-cally significant differences in the parity,history of cesarean section,delivery mode,degree of placenta accreta,missed diagnosis rate,neonatal birth weight,and hysterectomy rate between the non-anterior placenta accrete group and the anterior placenta accreta group.In the case of prenatal diagnosis of different degrees of placenta accreta,the prenatal diagnosis rate of placental adhesion in the non-anterior placenta accreta group was lower than that of the anterior placenta accreta group,which was statistically significant.In the non-anterior placenta accrete group,there were statistically significant differences in the age,cesarean section history,placenta previa status,mode of delivery,degree of implantation,24-hour bleeding volume,blood transfusions,NICU transfer rate,uterine loss rate between the intrapartum diagnosis group(missed diagnosis)and the prenatal diagnosis group.Conclusions The high-risk factors of patients with non-anterior placenta accreta are different from those of patients with anterior placenta accreta.Multiple births and a history of cesarean section are high-risk factors for anterior placenta accreta patients.Non-anterior placenta accreta are more likely to be missed diagnosed,especially the placental adhesion.For pregnant women with non-anterior placenta accreta missed diagnosis,there is a high rate of adverse birth out-comes,especially in the rate of neonatal transfer to the NICU.

Objective:To establish a polymerase chain reaction(PCR)method to accurately discriminate the crude materials and aqueous extract of Zaocys dhumnades,Elaphe carinata,Elaphe meollendorff and Ptyas korros.Methods:Specific primers were designed using mitochondrial Cytb gene(CO1)as a target gene,and annealing temperature,number of cycles and the type of DNA polymerases were optimized.The mixed samples were detected by this method.Results:By this multiplex allele-specific PCR identification method,135,182,246 and 197 bp of specific fragments were amplified from DNA templates of Zaocys dhumnades,Elaphe carinata,Elaphe meollendorffi and Ptyas korros,respectively,following the conditions:cycle number of 35,annealing temperature of 62 ℃.The adulterants and the blank control showed no bands.The method could simultaneously and accurately identify the snake-derived components in the mixed samples.Conclusion:The method can be used to identify the samples of Zaocys dhumnades,Elaphe carinata,Elaphe meollendorffi and Ptyas korros simultaneously,accurately and rapidly,and is suitable for the identification of standard decoctiond and formula granules samples.

Objective To explore the mechanism of diabetic kidney disease(DKD)with Qigui Didang Decoction.Methods Using network pharmacology,the potential components and targets of Qigui Didang Decoction for DKD were obtained.The docking mode between the core target and key components was simulated with molecular docking technology.Finally,the effect of Qigui Didang Decoction on db/db mice was observed,and the mechanism of DKD improvement was verified from the level of in vivo experiment.Results 117 potential active ingredients,427 drug targets,and 2151 disease targets were obtained.KEGG enrichment analysis of 183 intersection targets revealed that the phosphatidylinositol 3 kinase(PI3K)/protein kinase B(PKB/Akt)signaling pathway may be one of the action pathways.Molecular docking revealed that AKT1 and TNF had strong binding forces with hederagenin,stigmasterol,and beta-sitosterol.In vivo,studies have shown that Qigui Didang Decoction improves the general conditions,renal function,blood glucose,and lipid levels in db/db mice,reverses kidney injury and necrosis,and significantly downregulates the protein expression of PI3K,p-Akt,and tumor necrosis factor-α(TNF-α)in db/db mice.Conclusion Qigui Didang Decoction plays a role in regulating glucose and lipid metabolism and inflammation,and promoting the activation of the PI3K/Akt signaling pathway may be an important mechanism.

Objective::To use fetal heart quantification ( fetal HQ) technology to compare the coarctation of the aorta (CoA) and normal fetal heart structure and systolic function and to assess whether there are abnormalities in the fetal heart structure and systolic function associated with CoA. Methods::This prospective cohort study was conducted from May 2020 to December 2022 and involved 18-40-week-old singleton pregnancies and 30 fetuses diagnosed with CoA using fetal echocardiography at the General Hospital of Ningxia Medical University and Peking University First Hospital Ningxia Women’s and Children’s Hospital, China. The control group contained 60 normal fetuses. The following parameters were recorded and analyzed statistically: four-chamber view (4CV) end-diastolic long diameter, 4CV epicardial-contralateral epicardial transverse maximum diameter, 4CV global sphericity index (GSI), left ventricular (LV) and right ventricular (RV) 24-segment end-diastolic diameter (EDD), 24-segment sphericity index (SI), LV-fractional area change (LV-FAC), LV-longitudinal strain (LV-LS), RV-fractional area change (RV-FAC), RV-longitudinal strain (RV-LS), and LV and RV 24-segment transverse fractional shortening (FS). Measurement data were compared between the two groups using an independent sample t test, with P < 0.05 indicating statistically significant differences. Moreover, the correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS was assessed. Results::Within and between observer comparisons of the parameters associated with major cardiac function revealed an intragroup correlation coefficient of >0.9, indicating high consistency, and a coefficient of variable of <1 %, indicating low variability. Correlation analysis revealed no obvious correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS. A comparison of the four-chamber morphological structural parameters of the hearts in the two groups revealed that when compared with the control group, the 4CV end-diastolic long diameter was shortened in fetuses in the CoA group and the epicardial-contralateral epicardial transverse maximum diameter was wider, while the GSI was lower ( P < 0.05). A comparison of the LV and RV morphological structure parameters between the two groups revealed that when compared with the control group, the LV’s 24-segment EDD was smaller in the CoA group, the RV’s 24-segment EDD was greater in the control group, the SI of the LV’s segments 16-24 was greater than in the control group, and the SI of the RV’s segments 7-24 was less than in the control group (all P < 0.05). When compared with fetuses in the control group, the LV’s segments 16-24 were greater in the CoA group, whereas the RV’s segment 6-24 was smaller ( P < 0.05). When compared with the control group, LV-FAC, RV-FAC, and LS were lower in the CoA group ( P < 0.05). The FS of the LV segments 1-24 and the FS of the RV segments 1-16 were smaller in the CoA group than in the normal group ( P < 0.05). Conclusion::Fetal HQ, a new simple technique that offers rapid analysis and high repeatability, can quantitatively evaluate structural and systolic function changes in fetuses with CoA.

Objective::To use fetal heart quantification ( fetal HQ) technology to compare the coarctation of the aorta (CoA) and normal fetal heart structure and systolic function and to assess whether there are abnormalities in the fetal heart structure and systolic function associated with CoA. Methods::This prospective cohort study was conducted from May 2020 to December 2022 and involved 18-40-week-old singleton pregnancies and 30 fetuses diagnosed with CoA using fetal echocardiography at the General Hospital of Ningxia Medical University and Peking University First Hospital Ningxia Women’s and Children’s Hospital, China. The control group contained 60 normal fetuses. The following parameters were recorded and analyzed statistically: four-chamber view (4CV) end-diastolic long diameter, 4CV epicardial-contralateral epicardial transverse maximum diameter, 4CV global sphericity index (GSI), left ventricular (LV) and right ventricular (RV) 24-segment end-diastolic diameter (EDD), 24-segment sphericity index (SI), LV-fractional area change (LV-FAC), LV-longitudinal strain (LV-LS), RV-fractional area change (RV-FAC), RV-longitudinal strain (RV-LS), and LV and RV 24-segment transverse fractional shortening (FS). Measurement data were compared between the two groups using an independent sample t test, with P < 0.05 indicating statistically significant differences. Moreover, the correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS was assessed. Results::Within and between observer comparisons of the parameters associated with major cardiac function revealed an intragroup correlation coefficient of >0.9, indicating high consistency, and a coefficient of variable of <1 %, indicating low variability. Correlation analysis revealed no obvious correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS. A comparison of the four-chamber morphological structural parameters of the hearts in the two groups revealed that when compared with the control group, the 4CV end-diastolic long diameter was shortened in fetuses in the CoA group and the epicardial-contralateral epicardial transverse maximum diameter was wider, while the GSI was lower ( P < 0.05). A comparison of the LV and RV morphological structure parameters between the two groups revealed that when compared with the control group, the LV’s 24-segment EDD was smaller in the CoA group, the RV’s 24-segment EDD was greater in the control group, the SI of the LV’s segments 16-24 was greater than in the control group, and the SI of the RV’s segments 7-24 was less than in the control group (all P < 0.05). When compared with fetuses in the control group, the LV’s segments 16-24 were greater in the CoA group, whereas the RV’s segment 6-24 was smaller ( P < 0.05). When compared with the control group, LV-FAC, RV-FAC, and LS were lower in the CoA group ( P < 0.05). The FS of the LV segments 1-24 and the FS of the RV segments 1-16 were smaller in the CoA group than in the normal group ( P < 0.05). Conclusion::Fetal HQ, a new simple technique that offers rapid analysis and high repeatability, can quantitatively evaluate structural and systolic function changes in fetuses with CoA.

Objective To explore the mechanism of diabetic kidney disease(DKD)with Qigui Didang Decoction.Methods Using network pharmacology,the potential components and targets of Qigui Didang Decoction for DKD were obtained.The docking mode between the core target and key components was simulated with molecular docking technology.Finally,the effect of Qigui Didang Decoction on db/db mice was observed,and the mechanism of DKD improvement was verified from the level of in vivo experiment.Results 117 potential active ingredients,427 drug targets,and 2151 disease targets were obtained.KEGG enrichment analysis of 183 intersection targets revealed that the phosphatidylinositol 3 kinase(PI3K)/protein kinase B(PKB/Akt)signaling pathway may be one of the action pathways.Molecular docking revealed that AKT1 and TNF had strong binding forces with hederagenin,stigmasterol,and beta-sitosterol.In vivo,studies have shown that Qigui Didang Decoction improves the general conditions,renal function,blood glucose,and lipid levels in db/db mice,reverses kidney injury and necrosis,and significantly downregulates the protein expression of PI3K,p-Akt,and tumor necrosis factor-α(TNF-α)in db/db mice.Conclusion Qigui Didang Decoction plays a role in regulating glucose and lipid metabolism and inflammation,and promoting the activation of the PI3K/Akt signaling pathway may be an important mechanism.