In November 2023, the seventh National Nucleic Acid Vaccine Conference was held to deeply discuss the immune mechanism, safety risks, advantages, and disadvantages of nucleic acid vaccines, and review the safety and effectiveness of COVID-19 vaccines developed by nucleic acid vaccine technology. Some prospectives were formed in the meeting that in the post-pandemic era, nucleic acid vaccine technology will play a role in the following areas: dealing with pathogens that are difficult to be prevented by traditional vaccines, promoting the upgrading of traditional live attenuated vaccines, contributing to the development of multivalent and combined vaccines, and rapid response to emerging and re-emerging infectious diseases. These views point out the direction for the future development of nucleic acid vaccine technology.

Pediatric acute hyperextension spinal cord injury (SCI) named as PAHSCI by us, is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training, which has been increasingly reported. At present, it has become the leading cause of SCI in children, and brings a heavy social and economic burden. Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards, specifications or guidelines. In order to provide standardized guidance, the expert team formulated this guideline based on the principles of science and practicability, starting from the diagnosis, differential diagnosis, etiology, admission evaluation, treatment, complications and prevention. This guideline puts forward 23 recommendations for 14 related issues.
Child ; Humans ; Spinal Cord Injuries/complications* ; Spinal Cord

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death, and most patients with HCC are diagnosed at an advanced stage. Before 2017, tyrosine kinase inhibitors were the main drugs for the treatment of advanced hepatocellular carcinoma. With the emergence of immune checkpoint inhibitors (ICIs), immunotherapy has gradually brought new hope to such patients. At present, the combination of ICIs and other systemic or local treatments has become a potential strategy for the treatment of advanced hepatocellular carcinoma, and some of these combinations have been included in large-scale clinical trials. The main challenges of immunotherapy for advanced hepatocellular carcinoma include the exploration of predictive biomarkers, management of immune-related adverse events, and exploration of effective combination regimens. This article provides the latest research progress on the single or combined use of ICIs and other immunotherapy for hepatocellular carcinoma and discusses the limitations of current research and clinical application and the future development direction.

Objective: We aimed to explore the feasibility of a single-port thoracoscopy- assisted five-step laparoscopic procedure via transabdominal diaphragmatic(TD) approach(abbreviated as five-step maneuver) for No.111 lymphadenectomy in patients with Siewert type II esophageal gastric junction adenocarcinoma (AEG). Methods: This was a descriptive case series study. The inclusion criteria were as follows: (1) age 18-80 years; (2) diagnosis of Siewert type II AEG; (3) clinical tumor stage cT2-4aNanyM0; (4) meeting indications of the transthoracic single-port assisted laparoscopic five-step procedure incorporating lower mediastinal lymph node dissection via a TD approach; (5) Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1; and (6) American Society of Anesthesiologists classification I, II, or III. The exclusion criteria included previous esophageal or gastric surgery, other cancers within the previous 5 years, pregnancy or lactation, and serious medical conditions. We retrospectively collected and analyzed the clinical data of 17 patients (age [mean ± SD], [63.6±11.9] years; and 12 men) who met the inclusion criteria in the Guangdong Provincial Hospital of Chinese Medicine from January 2022 to September 2022. No.111 lymphadenectomy was performed using five-step maneuver as follows: superior to the diaphragm, starting caudad to the pericardium, along the direction of the cardio-phrenic angle and ending at the upper part of the cardio-phrenic angle, right to the right pleura and left to the fibrous pericardium , completely exposing the cardio-phrenic angle. The primary outcome includes the numbers of harvested and of positive No.111 lymph nodes. Results: Seventeen patients (3 proximal gastrectomy and 14 total gastrectomy) had undergone the five-step maneuver including lower mediastinal lymphadenectomy without conversion to laparotomy or thoracotomy and all had achieved R0 resection with no perioperative deaths. The total operative time was (268.2±32.9) minutes, and the lower mediastinal lymph node dissection time was (34.0±6.0) minutes. The median estimated blood loss was 50 (20-350) ml. A median of 7 (2-17) mediastinal lymph nodes and 2(0-6) No. 111 lymph nodes were harvested. No. 111 lymph node metastasis was identified in 1 patient. The time to first flatus occurred 3 (2-4) days postoperatively and thoracic drainage was used for 7 (4-15) days. The median postoperative hospital stay was 9 (6-16) days. One patient had a chylous fistula that resolved with conservative treatment. No serious complications occurred in any patient. Conclusion: The single-port thoracoscopy-assisted five-step laparoscopic procedure via a TD approach can facilitate No. 111 lymphadenectomy with few complications.
Male ; Female ; Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Diaphragm/surgery* ; Retrospective Studies ; Feasibility Studies ; Esophagogastric Junction/surgery* ; Lymph Node Excision/methods* ; Stomach Neoplasms/pathology* ; Laparoscopy/methods* ; Gastrectomy/methods* ; Esophageal Neoplasms/pathology* ; Adenocarcinoma/pathology* ; Thoracoscopy

Sudden unexpected death in epilepsy(SUDEP)is the leading cause of accidental death in epileptic patients.The postictal generalized EEG suppression(PGES)is related to SUDEP.The age,seizure type,tonic seizure/tonic muscle contraction,ictal and post-ictal respiratory dysfunction and autonomic dysregulation is associated with PGES with significant individual variation.Progressive slowing of clonic phase(PSCP)in generalized tonic-clonic seizures(GTCS)is an independent predictor of the onset and prolongation of PGES.

Abstract: - （ ） ， Work related musculoskeletal disorders WMSDs are common occupational diseases in construction workers which have a high prevalence rate and involve a large number of construction workers. WMSDs affect daily work and quality of life of ， patients leading to absenteeism and burden. The main body parts of construction workers suffering from WMSDs are lower back/ ， ， ， ， ， waist neck shoulder knee elbow and hand/wrist and most of the patients are complicated in multiple sites. The prevalence ， of WMSDs varies by site with the lower back/waist being the most common sites. The influencing factors of WMSDs in （ ， ， ， ， ， construction workers mainly include individual factors age years of work gender smoking status sleep habits physical ， ）， （ ， ， ， fitness and physical exercise etc. occupational factors work load job type working posture work organization and ， ） management working environment and social psychological factors. The incidence of WMSDs is the result of multiple factors. ， ， Therefore tertiary prevention is the key to the prevention and control of WMSDs especially the etiological prevention. Chinese ， construction industry is in the period of rapid development and the demand of construction workers is large. It is urgent to carry out epidemiological and intervention studies on WMSDs for construction workers to guide the formulation of relevant guidelines and measures for prevention and control of WMSDs.

Abstract: - （ ） ， Work related musculoskeletal disorders WMSDs are common occupational diseases in construction workers which have a high prevalence rate and involve a large number of construction workers. WMSDs affect daily work and quality of life of ， patients leading to absenteeism and burden. The main body parts of construction workers suffering from WMSDs are lower back/ ， ， ， ， ， waist neck shoulder knee elbow and hand/wrist and most of the patients are complicated in multiple sites. The prevalence ， of WMSDs varies by site with the lower back/waist being the most common sites. The influencing factors of WMSDs in （ ， ， ， ， ， construction workers mainly include individual factors age years of work gender smoking status sleep habits physical ， ）， （ ， ， ， fitness and physical exercise etc. occupational factors work load job type working posture work organization and ， ） management working environment and social psychological factors. The incidence of WMSDs is the result of multiple factors. ， ， Therefore tertiary prevention is the key to the prevention and control of WMSDs especially the etiological prevention. Chinese ， construction industry is in the period of rapid development and the demand of construction workers is large. It is urgent to carry out epidemiological and intervention studies on WMSDs for construction workers to guide the formulation of relevant guidelines and measures for prevention and control of WMSDs.

Abstract: - （ ） ， Work related musculoskeletal disorders WMSDs are common occupational diseases in construction workers which have a high prevalence rate and involve a large number of construction workers. WMSDs affect daily work and quality of life of ， patients leading to absenteeism and burden. The main body parts of construction workers suffering from WMSDs are lower back/ ， ， ， ， ， waist neck shoulder knee elbow and hand/wrist and most of the patients are complicated in multiple sites. The prevalence ， of WMSDs varies by site with the lower back/waist being the most common sites. The influencing factors of WMSDs in （ ， ， ， ， ， construction workers mainly include individual factors age years of work gender smoking status sleep habits physical ， ）， （ ， ， ， fitness and physical exercise etc. occupational factors work load job type working posture work organization and ， ） management working environment and social psychological factors. The incidence of WMSDs is the result of multiple factors. ， ， Therefore tertiary prevention is the key to the prevention and control of WMSDs especially the etiological prevention. Chinese ， construction industry is in the period of rapid development and the demand of construction workers is large. It is urgent to carry out epidemiological and intervention studies on WMSDs for construction workers to guide the formulation of relevant guidelines and measures for prevention and control of WMSDs.

Abstract: - （ ） ， Work related musculoskeletal disorders WMSDs are common occupational diseases in construction workers which have a high prevalence rate and involve a large number of construction workers. WMSDs affect daily work and quality of life of ， patients leading to absenteeism and burden. The main body parts of construction workers suffering from WMSDs are lower back/ ， ， ， ， ， waist neck shoulder knee elbow and hand/wrist and most of the patients are complicated in multiple sites. The prevalence ， of WMSDs varies by site with the lower back/waist being the most common sites. The influencing factors of WMSDs in （ ， ， ， ， ， construction workers mainly include individual factors age years of work gender smoking status sleep habits physical ， ）， （ ， ， ， fitness and physical exercise etc. occupational factors work load job type working posture work organization and ， ） management working environment and social psychological factors. The incidence of WMSDs is the result of multiple factors. ， ， Therefore tertiary prevention is the key to the prevention and control of WMSDs especially the etiological prevention. Chinese ， construction industry is in the period of rapid development and the demand of construction workers is large. It is urgent to carry out epidemiological and intervention studies on WMSDs for construction workers to guide the formulation of relevant guidelines and measures for prevention and control of WMSDs.